If you’re looking for a way to control fraud, contain costs and boost productivity, consider utilizing Data Dimensions’ expert team for your Medical Claims Adjudication needs. Data Dimensions is a leader in the field, and our adjudicators receive comprehensive training in procedures, techniques and judicial requirements related to adjudication. They’re also trained on your company’s specific platform, and their training continues to ensure that they remain knowledgeable regarding constantly-changing adjudication information.
Data Dimensions’ Medical Claims Adjudication processing includes the following elements:
- Adjudicating entitlement
- Identifying duplicate claims
- Analyzing validity of claims and fraud detection
- Extricating “data components” from raw claims
- Calculating valid claim amounts
- Establishing medical service provider types
- Validating data against the adjudicating engine
- Committing fully adjudicated claims
Data Dimensions project managers will work with your organization to create a detailed project plan, verify requirements and determine the critical success factors that will satisfy your claims adjudication needs. Also, a comprehensive plan will be developed to define communication channels, and client-specific training will include full-supervision with 100 percent auditing until the team-in-training is ready, earning client satisfaction.