Healthcare Claims Administration Service
- Electronic claims receipt via real time, batch, email or fax
- Paper claims are scanned/ imaged and indexed
- Validation of Claims, Membership and Service Provider
- Electronic application of clinical funding and protocols
- Benefit Validation
- Payment Instructions to members or healthcare providers
- Quality Assurance to measure accuracy including random sampling of claims processed per employee per month
- Delivery of detailed and accurate claims statements
- Management of specialised claims such as ex gratia or third party claims.
Claims Administration Factsheet
