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Breakthrough Technologies Services in Outsourcing Healthcare | Outsourcing Call center | Outsourcing Engineering | Knowledge process OutsourcingBreakthrough Technologies Services in Outsourcing Healthcare | Outsourcing Call center | Outsourcing Engineering | Knowledge process OutsourcingInsurance Verification Outsourcing
Breakthrough Technologies Services in Outsourcing Healthcare | Outsourcing Call center | Outsourcing Engineering | Knowledge process OutsourcingInsurance Verification Outsourcing

 
 


Setting Targets


In order to set a defined target the following should be identified first:

  • Understanding the normal turnaround time of payment for each carrier (Major carriers both federal and commercial).
  • Set an average turnaround time for the project as a whole .

Then work out the following:

  • Take the total insurance AR (Accounts Receivables) for the project as a whole.
  • Eliminate claims filed/Re-filed during the period starting from the date this target is prepared to going back to completion of the average turnaround time date i.e the claims which are with in the average turnaround time.
  • Eliminate claims that are beyond this period but which has certain issues, which have still remained, unresolved
  • On the balance arrive at; apply the average collection rate for the project as a whole. The Auditor should work towards target

There are five possibilities would result in insurance follow up.

  • Insurance did not received the claims (bullets is missing)
  • Claim in process
  • Claim pending ( for additional information / documents / medical records)
  • Claim paid
  • Claim denied.
Insurance Verification Outsourcing