Whether we talk about medical claims processing or insurance data management, efficient claims processing requires a high level of accuracy along with timely data delivery.
Additionally, the efficiency of a company’s claims function can often act as a measure of its client satisfaction while also playing a crucial role in regulating the balance sheets for summarizing payouts and premiums against expected profit or revenue.
Clutch has released its list of top BPO Firms across different sectors and ARDEM ranks 2nd on the list of the best BPO Firms for claims processing while also ranking among the top outsourcing companies for data entry, back-office support, payment processing, and virtual assistance.
We are grateful to our clients for their reviews and to Clutch for featuring us as a top BPO firm year after year.
Successfully processing a claim entails fulfilling the insurer’s obligation to receive, investigate and process a claim application filed by the insured party.
The entire process starts with the submission of a medical or insurance claim by the insured party and moves on to application processing and authentication, followed by reimbursement.
However, errors such as incorrectly filled or incomplete details can result in the claim being rejected or even denied.
According to the latest report on claims processing released by Accenture, an ongoing, systematic study of insurance claims performance dating back to the 1990s has shown a mixed bag of successes and clear signs that the industry overall continues to struggle to achieve durable performance improvements.
As a top claims processing solutions provider, ARDEM provides precision processing and verification for higher approval rates, to reduce your administrative costs, decrease cycle time, and significantly boost production and revenue.
Let’s discover what sets ARDEM’s solution apart from the others to deliver high-performing solutions for our clients’ claims processing needs.
The ARDEM Advantage in Claims Processing
Implementing Greater Operational Efficiency
ARDEM employs a proprietary data entry methodology that combines OCR data capture and automated extraction with effort-based processing for faster and more reliable results.
The data extracted from medical claims or insurance applications is further passed through a series of quality and validation protocols to ensure the highest possible accuracy in the quickest possible time.
Additionally, with faster data processing and delivery, you also gain greater transparency and visibility into your operations and can keep tabs on the number of applications received, processed, verified, or even denied.
This further allows you to forecast expected payouts against the incoming premiums for better cash flow management and take steps to improve and impact your bottom line.
Accelerating Data Delivery
While time is of the essence in every industry, timely data delivery is critical in the insurance industry as there are set deadlines for filing, and failure to do so that can result in claim denial.
It’s especially true for medical claims as all claims must be filed within specified deadlines to get reimbursement or face rejection. The task is further complicated by the fact that Medicaid claims must adhere to both federal and state guidelines, and Medicaid programs differ from state to state.
With ARDEM, you get to experience faster turnarounds with our-state-of-the-art processes executed by proprietary software bots that are specially-coded for claims data extraction and processing. We have processed millions of claims forms in both the medical and insurance sector, creating a database of countless templates and filing specifications to make claims processing a breeze.
Offering Superior Skills and Infrastructure
As per Accenture, nearly a quarter or 25 percent of companies say they are still using claims systems that are mainly manual and paper-based.
This means that the claims processing continues to be bogged down by bottlenecks such as manual processing, careless data entry errors, inconsistent delivery, misplaced or missing forms, etc.
The need of the hour is using the right infrastructure, i.e., high-speed scanners and automated data processing for smarter claims processing. At ARDEM, we are capable of processing both digital and paper-based forms, we digitize, and index all forms received using our high-speed scanners for faster turnarounds.
Once digitized and organized, the forms are uploaded onto our online digital collaboration platform and processed using a combination of optical character recognition (OCR), advanced automation, and machine learning that ensure both speed and accuracy.
Enjoy Instant Scalability with High-Performance Remote Teams
Another advantage of outsourcing claims processing is that instead of having to undertake the hassle of hiring and training highly skilled resources to adapt to your processes, you can simply outsource this task to a team of trained professionals at a fraction of the cost.
When you outsource your claims processing to ARDEM, we get started by diving deep to understand your existing process, immediate requirements, and future goals.
Our process engineers and training specialists then get down to create a specialized training regime to build you a team of high-performing virtual analysts. The customized training regime recreates your process on our servers, where we instruct and monitor our analysts.
Moreover, the analysts transition to the live process only after they have reached the expected level of efficiency. We further continue to monitor and evaluate their performance while also tweaking our processes to provide consistently better results. As your processing needs expand, we allocate more software bots and more analysts to handle the increased flow of applications.
Ensuring Security and Compliance
Insurance applications contain several data fields of sensitive information, such as identity and financial details, which need to be processed with great care and security.
As an ISO27001-certified company, ARDEM implements appropriate redundancies at multiple levels to ensure that your data stays protected and cannot be accessed by unauthorized team members. Additionally, all data is processed as per HIPAA, PHI, PII, and GDPR compliances for additional data security.
We can go on and on about our data security for days, for more information, ask about our security measures during initial discovery.
Leveraging Global Talent
In today’s digital age, one need not be limited by geographical barriers while scouting for talent.
With operations in the US, India, South America, and the Philippines, ARDEM builds you a team of qualified analysts to execute your claims cycles efficiently.
We further implement a 3-shift system to ensure round-the-clock operations and faster data delivery for your claim applications.
At ARDEM, we value creating successful solutions that help our clients work smarter and faster!
We process a variety of different medical, insurance, and dental claims such as UB-40, UB-92, CMS-1500, HCFA, and more!
We value building intimate, long-lasting, and mutually beneficial relationships with our customers. You can count on us to be always fast, always reliable, and always accurate.
If you would like to learn more about how we can upgrade and accelerate your claims processing, then get in touch with us for a free consultation today!
