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Home ›› BPO Services ›› Claims Processing Outsourcing

AccuClaim - Claims Processing Outsourcing

  Case Study  
  Find out how a leading health plan provider enjoys claims processing accuracy rates greater than 99.8% with a turn-around reduction from 6 days to less than 48 hours by outsourcing to HOVS.  
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HOV Services' AccuClaim claims processing solution represents a tightly integrated front-end claims process that delivers 100% digital claims submission, significantly reduces administrative costs, improves auto-adjudication rates and significantly reduces turnaround time.

HOVS processes over 400,000 claims a day and has extensive experience in converting all types of claims forms including HCFA and UB92 (Single / Multi / Attachment / COB), RX claims, Medicaid, Foreign claims, Superbills, Medicare RP, Dental, and Vision claims. Your non-standard paper claims can be converted as long as there are identifiable rules and procedures for conversion.

Mailroom and Imaging Services
HOVS is able to provide mailroom services in one of our existing mail centers or onsite at a client's location. All incoming claims and enrollment documents are digitized and the images transmitted to a domestic or offshore HOVS facility for data capture. While your documents are with us, we account for each and every claim leaving your facility and establish a tracking convention unique to your organization's business rules. Real time reports are available through our Central Tracking System, allowing clients to follow a claim document throughout production.

Healthcare Claims Processing Workflow

Data Capture
Once claims are received in one of HOVS' global data capture centers, our Six Sigma and TQM methodologies allows HOVS to offer quality levels exceeding 99.5%. The converted output is then downloaded into the customer's adjudication system and remotely accessed in order to manually adjudicate all claims that are not accepted through auto adjudication. HOVS Claims Processing Professionals are Trained to Think and Decide, Not Just Key.

Archival Services
With document DNA, our online document storage and retrieval solution, HOVS will host the archival application while you assign document access parameters through a secure web connection. Whether you are storing EOBs, claims or membership applications, document DNA will eliminate the headaches of choosing, maintaining and upgrading document imaging systems. Additionally, document DNA creates a virtual customer service department, so you no longer have multiple disjointed customer service locations, but rather one single, virtual platform all customer service representatives can utilize.

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