Medical Claims Processing

Reduced costs. Expedited processing.
Improved compliance and Security.

Many of the nation’s largest insurers depend on Data Dimensions for their medical claims processing, as well as document management for non-claim mail. Each year, Data Dimensions processes millions of health insurance claims, medical records, insurance applications and enrollments annually. Combining our decades of industry experience and leading-edge technology, we convert a multitude of medical form types into high-quality images and data, and deliver claims information in the electronic data interchange (EDI) standard electronic format to any back-end system.

 

Data Dimensions has extensive experience with many claims related forms, including:

  • CMS-1500
  • UB92
  • Pharmacy
  • ADA forms
  • Dental X-rays
  • Provider-defined “Superbills”
  • Network claim forms
  • Pricing sheets
  • Prescription receipts
  • Explanation of benefit statements

Our services help insurers optimize the medical claims process to significantly:

  • Increase auto-adjudication rates
  • Reduce administrative costs
  • Accelerate reimbursement turnaround

Data Dimensions incorporates an insurer’s eligibility and provider databases into our capture and validation processes, along with standard CPT validations. We also can incorporate edits specific to an insurer’s medical claims system into our processes to enhance the data import. We customize the system to meet the insurer’s specific challenges and unique needs.

Why outsource medical claims processing to Data Dimensions?

  • Greater profits through expedited medical claims processing
  • Reduced transaction costs
  • Reduced time and money spent on overhead functions which have little impact on the actual outcome of medical claims
  • Secure online access for exception management and guaranteed sharp images/x-rays and bills
  • HIPAA compliance and protection
  • Audit trails for real-time reviews and complete process transparency

Data Dimensions understands that insurers have different business rules and processing requirements. Using Project Management Institute® (PMI) methodologies, a dedicated, experienced Project Manager works with your team to gather and understand your requirements, and builds upon those to design a workflow that allows for your unique needs, while giving you guidance to best practices.

Data Dimensions effectively integrates technology, experienced personnel and flexibility to provide you with the best outsourcing solution.