DME Service Solutions

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Claims Submission

Our advanced Claims Submission process guarantees accuracy in every detail, minimizing rejections and expediting approvals. Our team stays up-to-date with the latest regulations, ensuring industry-standard adherence for each claim.

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Reduce administrative burden with our Stress-Free Claims Submission journey

Our specialized Claims team handles denials directly to maximize reimbursements for your services. Let your team focus on exceptional healthcare customer care while we manage the tedious tasks of Claims Submission, Claims Processing, follow-ups, and reconciliations.

Our Healthcare Claims Submission Steps

  • STEP 1: CLAIM INTAKE

    When healthcare providers submit claims to the insurance company, our system receives detailed information about the provided medical services and associated costs.

  • STEP 2: CLAIM ASSESSMENT

    Our team evaluates insurance claims meticulously, ensuring validity within the specified timeframe. This involves cross-checking medical records, identifying duplicates, and confirming details' accuracy.

  • STEP 3: CLIENT VERIFICATION

    To ensure process integrity, our system verifies if the healthcare client is registered and benefits from active insurance coverage.

  • STEP 4: CLAIM DECISIONS

    Based on a thorough review, our specialists determine whether to approve or reject the claim. If a claim is denied, there is a well-documented rationale to support the decision.

  • STEP 5: PAYMENT EXECUTION

    Once a claim is approved, we ensure that insurance companies promptly disburse funds to healthcare providers within a predefined timeframe.

  • STEP 6: FACILITATION OF APPEALS

    If a claim is rejected, healthcare providers or patients can contest it. Our team supports this appeal process, often requiring the provision of additional data to strengthen the claim.

  • STEP 7: BILLING AND EOB DISPATCH

    We bill the insured party for any medical services not covered by insurance and provide a detailed Explanation of Benefits (EOB) statement, outlining service charges and coverage.

Our Streamlined Claims Submission Services

Ensures the claims experience, streamlining operations and delivering timely, premium care to all stakeholders, from care providers to recipients.

Conduct thorough audits and evaluations to ensure precise claim processing that strictly adheres to regulatory standards.

We monitor claim statuses, identify trends, and optimize our client's revenue cycle for informed decision-making.

Build your outsourced team with DME Claim Handling Services. Start streamlining performance and reducing in-house costs.

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Why Choose Our Healthcare Claims Management Services

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Cost Effective

Our services include specialized insurance claim teams, eliminating the need for you to expand your in-house staff. Say goodbye to investing in extra office space, hardware, and associated overheads.

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Human-centered Experience

Our claims processing teams offer a human touch to ensure efficient and empathetic responses for superior customer experiences. By integrating our expertise, we streamline processes, enhance client satisfaction, and minimize issues.

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Higher Success Rate

The effectiveness of our team shines through in the swift and accurate handling of insurance claims. Trust in us, and we guarantee unparalleled effectiveness in every processed claim.

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Productivity Increase

Partnering with our experts allows your in-house team to focus on their primary roles, driving excellence and streamlining claims handling. Rediscover your team's potential as they align with your organization's objectives.

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DME Service Solutions - The Leading Service Provider with Health Insurance Claims Processing

At DME Service Solutions, we take pride in being a human-centered BPO company that caters specifically to the healthcare industry. Our team is highly engaged and specialized to meet your unique requirements. We understand the importance of customer satisfaction and strive to provide tailored solutions that enhance your operations. Our commitment to partnering closely with you sets us apart in the industry and allows us to deliver the best possible service. At DME Service Solutions, our goal is to help you achieve your objectives and exceed your expectations.

+347%

Maintained support for Increase in call volume

-41%

Decrease in average days to collect documents

~15

Days average TAT for hiring

+166%

Increase CGM Orders YOY Q1-22 vs Q1-23

94%

Consistent service level results

-17%

Decrease in avg handling time​

Build your outsourced team to streamline your business performance and increase your customer satisfaction.

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