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Solve These Medical Claims Processing Issues in 2023 with Outsourcing.

By January 9, 2023No Comments
Healthcare medical claims processing outsourcing blog

Medical claim processing involves a dozen steps as medical/insurance service providers need to assess numerous medical codes to determine reimbursement. There are unique medical codes that describe healthcare services, corresponding diagnosis codes, procedure codes, date of service, attending physician’s National Provider Identifier (NPI) number, charge for the service, and many other details. It is evitable to go through each detail to process the bill correctly and within a specific time period. 

There are ways to ensure accuracy and improve efficiency for this complex workflow. The most utilized solution is outsourcing medical claims management services. Companies prefer an experienced business process service company (BPO company) to take care of their medical claims management. The ongoing pandemic has pushed significant growth in the healthcare and insurance industry, making more companies outsource their medical claim services

Various Issues with Medical Claims Outsourcing

1. Confidentiality and Data Security


The concept of data security and protection against a security breach is a concern that evolved with technological development. Therefore, thorough research about which healthcare BPO service provider to hire is necessary. Unauthorized disclosure of data or information about a patient violates the act of confidentiality and data privacy.

2. Miscommunication to Know About Claim Processes

Team Composition

Clarity of processes and concepts is important for any business partnership. Miscommunication between the medical billing outsourcing service provider and the facility may lead to insufficient access to necessary information and raise many internal and external issues.

3. High Expectation

Some medical facilities may have extremely high expectations from their BPO service partner. They need to look at how experienced the teams in the company are before hiring them. Know the project management teams and team members’ roles in processing the data. 

4. Organizational and Cultural Barriers

Globally progressing medical and insurance providers need a great pool of talent and they may need off-shoring services. They may have to go through corporate and regional barriers. Such differences can influence productivity.

5. Low Accuracy

Medical facilities may go through the issues of data accuracy which is of utmost importance for claim processing correctly. A BPO service provider needs to be advanced enough to provide the best data entry services.

Such issues can easily be resolved by an experienced BPO company. One of the leaders in the industry is ARDEM. 

ARDEM's Support in Medical Claim Processing

1. HIPAA Compliant

We implement a slew of security measures to protect your data.

The outsourcing partner must comply with strict data regulations to ensure maximum data protection. Reputed BPO service providers, like ARDEM, comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations. With the highest levels of security protocols with ARDEM, like HIPAA, its clients are assured about data security.

2. Dedicated Project Management

ARDEM serves its clients with dedicated project management. The project manager is the main point of communication between the client company and their team. They fully understand the project and ensure the smooth completion of the project.

3. Fully-Enhanced Workflow with Years of Experience


ARDEM has an experience of 20+years in providing business process outsourcing solutions. They deliver success to their valuable clients by combining the best people, and robust technologies. ARDEM has a diverse talent pool, and its clients can benefit from talents from across the globe.

4. High Accuracy

ARDEM provides medical claims data entry services with the facility of automation for high accuracy of up to 99.7%. It helps to decrease cycle time and administrative costs.

Thus, medical claims outsourcing with experienced BPO companies, like ARDEM, offers excellent potential for streamlined workflows.

ARDEM provides Business Process Outsourcing and Business Process Automation Services to established companies to help them improve operational Efficiency and Reduce Costs.  For more information please reach out to us  at or call us at 908-359-2600.