OUTSOURCED CLAIMS PROCESSING

Outsourced Claims Processing Lowers Cost. Improves Accuracy.

healthcare-benchmarkingLike many payers, you may have moved most of your claims submissions to an electronic format. But now your challenge is to get those paper claims into an EDI 837 file that the system can process. Maybe you’ve resorted to manually keying in each claim – at an even higher cost. Royale Class can help.

Royale Class can solve these issues by delivering 100% of your claims digitally. Outsourcing this function to Royale Class allows you to:

  • Achieve higher auto-adjudication and first-pass rates
  • Reduce claims rework and turnaround time
  • Reduce paper-related costs
  • Store critical documents online where they are easily accessible
  • Ensure confidentiality, privacy and strict HIPAA-compliance
  • Reduce pends
  • Increase time to process requirements

One client reported savings of 40% by imaging and storing their files digitally.

Royale Class can provide:

  • Mailroom processing
  • Imaging
  • Paper claim data entry via OCR
  • Workflow management
  • Image storage
  • Image retrieval
  • Electronic claims
  • Enrollment processing
  • Member and provider matching
  • PPO routing
  • EDI-to-image processing

Additionally, Royale Class offers:

Flexible delivery models.
You can outsource services on an ongoing basis, or as needed to complete “on demand” projects. And you can choose to outsource one piece of the business, or an entire business process.

Flexible sourcing models.
With professionals available to work around the clock, Royale Class can offer the same turnaround times as our off-shoring competitors. At a comparable price. And with a command of the English language that can’t be matched offshore. We can meet the scale, the scope and the cost demands of any payer organization.

Solutions that work – no matter what your platform is
Royale Class has been built, from the CEO down with extensive experience in claims, billing and enrollment. Our team has vast experience on most core administration systems, including Facets™, QNXT™, Qi clink™, PowerSTEPP® (XTEN), AMISYS, PowerMHS®, PowerMHC®, Diamond, Xcelys®, EZ-CAP®, Claims Manager, Health LX (LuminX), MetaVance®, GBASS and FACTS™.

Royale Class and you: a partnership that drives the greatest value for every healthcare dollar spent.

Get Royale Class results from your technology investments. Click here to contact Lori directly, or call us at (877) 219-0644.

TRIZETTO®, Facets, QicLink™ and QNXT are trademarks owned by The TriZetto Group, Inc. Royale Class Consulting is not affiliated with The TriZetto Group, Inc. and The TriZetto Group, Inc. neither sponsors nor endorses our materials, goods or services. All other trademarks are the property of their respective owners. Use of any trademark does not represent an affiliation with the trademark owner, nor does it represent sponsorship or endorsement on the part of the trademark owner.