Member Eligibility and Benefit Validation

• Verification of Patient’s Insurance and coverage determination play a vital role for any provider practice. Our experts help you with this process before the services are rendered. This enables your organization to act proactively so clean claims can be submitted.
• Our 24/7 customer care team excels in follow up with patients if required.

Claim Services

• Our global claims professionals have worked across multiple clients to drive up to 70% savings in administrative and medical costs.
• End to end support, for Claims submission and processing, through the entire claim life cycle.
• 70 percent productivity on targeted claims due to applied intelligence utilizing human and machine capabilities.
• We have developed a robust model for managing claims operations for our clients. These models have evolved through our vast experience in claims processing and offer our clients the most optimal way to process claims. Some of these models are based on categories of rejected claims, created by special teams assigned with the task of monitoring, understanding, and pursuing rejected claims, to completion.
• As one of the leading medical claims processing companies in the industry, we provide real time view of the claims cycle progress to our clients for better insights, so they can analyze the efficiency of the various stages of the medical claims management process. We also provide our clients with complete control over rejected claims.
• Itaeaon’s auditing and medical claims support services are a blend of highly qualified auditors and data processing applications. Our clients leverage this to audit claims, conduct underpayment analysis, identify and implement effective solutions for recovery, and post payments for all clean claims. We conduct audits to ensure that no fraudulent claims sneak their way into the system. Our claims processing audit also helps to ensure that the provider is adhering to the latest compliance regulations governing the claims.
• All these, together, make our medical claims processing services cost and time effective.

Medical Billing and coding services 

• Our Coding and billing solutions help end the struggle most practices face due to finding, training, and retaining administrative talent to help run the practice smoothly. At ITaeon, we provide world class Medical Coding and billing services, helping you eliminate resource wastage, so you can focus more of your time on providing excellent care.
• We perform proper review and assignment of codes based on illness, treatment, place of service & type of service as per the Coding guidelines before the claims are filed to the payers.
• We help avoid coding backlogs and simplify the claims process flow with no additional documentation, data, or vendor to manage, because of our experienced and certified coding team for HIPAA-compliance.
• Our services utilize cloud-based storage, and all the data exchange happens electronically, by strictly adhering to compliance protocols, so your data is safe and secure.
• Our professional team is well trained on data governance and management.

Provider Services

• Our services include provider credentialing, provider enrollment based on locations. Validation and verification of Provider Professional Records is performed from our end before the affiliation with Health Insurance Plans.
• Our perseverance to improve data accuracy, reduce turnaround time support your organizational goals of improving better provider relationships and compliance with the CMS guidelines.

Utilization Management 

• Our utilization review model uses prospective, concurrent, and retrospective assessments, and therefore- improved health outcomes of members, promoting maintenance of health and well-being.
• Obtaining prior authorizations, coding claims, and chasing denials take up valuable time and can negatively impact care. While we take ownership and accountability for thorough reviews at every level of revenue cycle management, your organization can remain focused on delivering great services.

Why work with us 

• Save up to 70% in total operational costs by leveraging our Advanced intelligent Analytics applications.
• Automation of the claims processing has helped many a client to strategically process claims, limiting delays and avoiding wrong disbursements.
• Applied analytics to improve revenue cycle management.
• Provide expedited resolutions to claims deficiencies such as missing data, errors in coding or prior authorization
• Manage all claims-related correspondence to ensure follow-up with the payer is frequently and rigorously made.
• Transform all documents into digital files so that all documentation can be stored in one large central, searchable data repository
• Provide comprehensive reporting for claims audits, adjudication, and settlement payment amounts in real-time.

Our services include, but are not limited to:

• Physician groups
• Individual providers
• Facilities/Care Centers/Nursing Homes
• Dentists
• Home based Palliative care services
• Chiropractors/Physio therapists
• Pharmacies, including specialty pharmacies.