Claim Adjudication & Claim Processing

 CLINEVA main focus is enhancing the administration process for insurance companies. Our experts achieve fast adjudication by combining different data management processes. We boost productivity by automation through new technology tools and improve functionality by developing suitable dashboards. Consecutively, this helps us in continuous process improvement.

Our expertise and innovative technological strengths ensure claim accuracies by scrutinizing claim records, i.e., patient names and diagnostic codes, and also process claims that are valid and reimbursable.

We offer advanced services through our robust claim management software and security systems, supporting our client’s security objectives by protecting the data. eExpedisehealth is equipped with intelligence tools delivering exceptional services with teams both in service and development.

  • Benchmarking competency parameters: Automating complex calculations to drive high auto-adjudication rates and reduce the risk of paying claims inaccurately.
  • Reduction in TAT by modified technology tools closely integrated with the claims processing system of the client.
  • Productivity enhancement and cost savings: Increasing productivity and reducing costs with detailed date tracking, including diagnosis, procedure, provider type, and units of time.
  • Eligibility check and detection of fraudulent claims: Making fraud review and detection possible through our data analysis tools even in underwriting, policy renewals, and periodic checks that fit right in with modelling.