Claims Processing

DocsHelpline intends to provide HIPAA compliant insurance claims processing.  The system as part of its phase II development would offer end-to-end solutions for insurance companies.  Insurance claims would involve Insurance data entry, insurance fraud detection, Claims adjudication services and re-pricing services

DocsHelpline would help Insurance Claims Manager to respond to claims, appeals and grievances.  Other than that Claims manager can investigate and responds to complaints regarding claims processing.  Performs claim reviews and makes recommendations based on policy provisions and processing guidelines.  Since EPrescription is tightly linked DocsHelpline helps Claims Manager to review activities such as as bill review, bill audits, subrogation and medical reviews

The Proposed Claims Module makes claims processing more efficient. Before submission, automatically scrubs and edits all claims against its constantly updated list of claims edits.

  1. Verify insurance benefits instantly
  2. Batch claims for electronic filing
  3. Transmit electronic CMS 1500 or UB04 claim forms
  4. Check the status of a claim in real time

Receive explanations of benefits (EOBs) within proposed module