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HOV Services’ AccuPay process delivers exceptional financial accuracy with fewer re-works, streamlined processes & significantly reduces adjudication costs. AccuPay enhances your claims adjudication capacity by providing access to highly skilled labor and proven processes.
- Benefit Analysis
- COB Edits
- Stop Loss Claims
- Flexibility on Volume Fluctuation
- Faster Processing/ Payment
- Multi-site Redundancy
HOV Services’ approach to claims adjudication is straightforward - utilize a skilled group of offshore professional claims adjudicators, a US-based operations group and a team of experienced IT professionals to deliver extraordinary service to Healthcare payers. HOV’s secure, outsourced solution will facilitate an adjudication cost savings of at least 30%.
All HOV Services healthcare professionals are trained on multiple adjudication platforms and plan designs. Our adjudicators are highly educated people with knowledge of medical terminology and who are proven analytical problem solvers. New adjudicators are trained in an intensive 5 week program covering the U.S. healthcare industry and claims adjudication. The program is administered by senior level U.S. based claims adjudicators who also serve as claim auditors.
Certified claims adjudicators go through client specific training to learn the client’s insurance plans, systems and claim types. HOV works with the client to create a detailed project plan, verify the requirements and determine the critical success factors that need to be met. In addition, a comprehensive communication plan is developed to define the communication channels and to review status, issues and amendments to plans. A dedicated Project Manager manages the entire process. During client specific training, our operation begins with full supervision and 100% claim review until the team in training becomes proficient and earns client certification.
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