Healthcare Payer

The current US Healthcare market encounters the challenges of managing the turnaround time for their critical business transaction.  Healthcare plans are looking forward to effective ways of improving Turnaround time, customer satisfaction and reducing cost without compromising on quality. The process requires efficient management of a huge volume of sensitive data and utmost security from fraudulence.

Finnastra’s KPO solution effectively addresses these challenges, trims down TAT and upholds high quality in an outsourced environment. Our portfolio of KPO solution spans all critical business functions and effectively manages TAT for transactions. Our team members have sufficient experience and highly skillful to manage large volume projects.

Claim Management

Finnastra’s work on claim management is tremendously a well set orchestra. We provide services ranging from one end to another to the people and insurance companies as well. The following displays the wide spectrum of services:

  • Claims Intake
  • Claims Pre – Adjudication
    • Claims Data Entry
    • Claims Validation
    • Provider Eligibility Validation
    • Member Eligibility Verification
    • Edit Resolution
  • Adjudication
    • Coding Verification
    • Edit Resolution
    • Claims Re-pricing
    • EOB Processing
    • Provider and Member Appeals handling
    • Claims Audit
    • Aged Claims Reporting
  • Post Adjudication
    • EOB Printing
    • Customer Service – Member and provider
    • Appeals and Grievance communication
  • Collection
    • Over payment and under payment processing
    • Provider and Member Follow-up and Recovery
    • Analysis Report
  • Audits
    • Reimbursement audits
    • Coding audits
    • DRG coding audits