Medical Claim Processing

Medical Claim Processing

SWIFT, ACCURATE &
HASSLE-FREE MEDICAL CLAIMS
PROCESSING IN THE USA

Get Robust Medical Claim Process Outsourcing Support For Maximizing Your Healthcare Claims

Fusion’s accurate and incredible medical claims processing services in the United States ensure easy & swift settlements and a high success rate. From forwarding insurance claims of patients to insurance verification and claims processing and settlements, our medical & healthcare claims processing will cover it all, enabling your healthcare organization to get paid on time.

What’s more? Our HIPAA-compliant practices will help you save massively on administrative expenses while also keeping your business protected from industry-specific regulatory compliances. Processing medical & health insurance claims can prove to be a highly tedious task, but it is also an integral aspect of your business. Moreover, there is a need to ensure maximum accuracy at every step of the claims processing stage. Even the smallest and simplest of errors can amount to massive financial losses and industry sanctions. That’s precisely why your medical and healthcare business needs our medical claims processing for maximum outcomes. We will ensure accurate claims verifications to maximize validations and settlements. This will, in turn, help your business maximize revenues and help you get paid for your professional services.

In addition, Fusion’s contact center solutions and customer support infrastructure will also help you offer superior customer engagements, delivering swift responses and appropriate resolutions to every customer. In the end, we will oversee every area of your customer and client engagements so that your core team of medical staff can provide more focus on delivering efficient and effective medical care to patients and their families.

Key Aspects of Our Medical & Healthcare Claims Processing Services in the USA

If you are considering outsourcing medical claims processing in the USA, the UK, Asia, and other major global locations, you needn’t look any further than Fusion. Our comprehensive claims processing solutions will not only help your business process health and medical insurance claims swiftly, but they will also ensure superior-quality customer and client engagement through convenient and effective communications. In addition, some of the most important aspects of our efficient, effective, and seamless claims processing solutions include:

  • Maximum Data Security – Our methods and practices are HIPAA-compliant and are certified by almost every industry-specific regulatory body. Hence, we follow all regulations to the letter, ensuring complete compliance management
  • Best-in-class Infrastructure – Fusion’s infrastructure (both hardware and software) is top-notch, utilizing the latest advancements in the technology and innovation space for our healthcare claims processing services
  • Automated Processes – We automate much of the data management and processing functions and several other practices. This helps to make our services seamless and reduces TAT for swifter resolutions and claims settlements
  • Maximum Accuracy – Our automated structures also help us to minimize human errors in claims submissions, verifications, and processing. This allows us to ensure maximum accuracy for our clients seeking top-quality outsourcing medical claims processing in the USA
  • Cost-Effective Solutions – Fusion’s wide range of customized solutions has something for every budget. With our cost-effective solutions, you can save plenty of money by only choosing the services that you need to ensure maximum outcomes for your business


Our Professional And Competent Healthcare And Medical Claims Processing Services Will Help Your Business Enjoy:

  • Stress-free claims submissions, processing, and settlements
  • Quicker TAT between the insurance claiming process and settlements
  • Reduced customer grievances and complaints
  • Timely and periodic reports to determine the current status
  • Incredibly high success rate with maximum claims settlements
  • Reduced operating expenses for insurance claims processing and customer engagement
  • Incredibly high success rate with maximum claims settlements
  • Improved relations with clients, vendors, and other business partners

With Fusion’s industry-specialized claims process outsourcing services and customized solutions, you will have access to highly effective practices to help your healthcare business submit and verify claims swiftly and ensure hassle-free settlements and on-time payments.

OUR CAPABILITIES

Insurance Verification

When an insurance claim is submitted, the insurance carrier will verify the claim against the policy to determine whether the insurance policy covers the customer’s medical treatments and to what extent. At Fusion, we can help you with accurate insurance verification to speed up the process significantly.

Coverage & Account Information Verification

Fusion’s extensive resources will help you determine which conditions and medical treatments the patient obtains are covered by their health and medical insurance policies. This information will aid in swift and convenient medical claim processing due to maximum accuracy in claim submissions.

Identifying Fraudulent Elements

Our team of professional experts will investigate and verify each insurance claim to understand its circumstances and determine its validity. Our thorough investigations will help you identify discrepancies, compliance failures, and fraudulent elements, rectifying them to help you avoid legal action in the future.

Claims Submissions & Verification

With all prior checks and investigations completed, our healthcare claim processing will accurately submit the insurance claims. We can also help insurance carriers conduct insurance claims verification to facilitate swift processing and quicker TATs, fostering better relations with clients and vendors.

Healthcare Insurance Claim Processing

Once the healthcare or medical insurance claim is submitted and verified, we will complete all the following stages to see it to its completion. With our professional guidance, the insurance claims will be processed at a faster pace and ensure quicker and on-time settlements for the healthcare facilities.

Easy & Swift Settlements

Fusion’s claim process outsourcing will ensure that the insurance claims are settled at the earliest for medical facilities and healthcare organizations to get paid faster. Our verifications and submissions will also ensure maximum coverage and insurance payouts, generating a massive revenue inflow.

Medical Necessity Review

We help medical facilities examine and determine the medical necessity of treatments and procedures suggested and billed by the doctor. We will check their validity according to industry best practices and patient safety requirements detailed by regulatory bodies, ensuring that the patients are billed appropriately.

Benefits Adjudication & Explanations

Apart from identifying the extent of coverage a patient can get from their insurance carriers, we also help to identify the treatments that aren’t covered. Once the benefits of their insurance coverages can be determined, we explain them to the patients and suggest the best next steps for the uninsured treatments.

Periodic & Timely Reports

Our comprehensive reporting system will offer daily, weekly, monthly, and other periodic reports for healthcare businesses to track insurance claims submissions and their statuses. The periodic and on-time reports of our outsourcing medical claims processing in the USA can be critical to your business operations.

Automated Process & AI-Powered Solutions

We are highly enthusiastic about digital transformations in business operations, infusing every function with the latest technological advancements. This has enabled us to automate several functions and create smart AI-powered solutions to deliver customers swift responses and quick resolutions.

THE FUSION FACTOR

27 Locations in
14 Countries

40+ Language
Support

6500+
Skilled
Agents

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    COUNTRIES WE ARE PRESENT IN

    Albania

    Use our competent and professional claims process outsourcing services to ensure swift and accurate claims submissions. This will, in turn, help you get prompt settlements and on-time payments from insurance carriers.

    Morocco

    Enable your healthcare business in Morocco to complete accurate insurance claims submissions that follow all industry-specific guidelines and regulations, which will enable you to ensure maximum settlements and revenues.

    United Kingdom

    With our sophisticated insurance claims processing services in the United Kingdom, you can maximize outcomes and benefit from a high success rate. We will help you get quick processing, settlements, and revenue inflow.

    India

    If you are looking for customized medical and healthcare claims processing services in India to meet customer needs from all corners of the country, our wide range of claims processing solutions is the ideal service you need to get.

    The Philippines

    Top healthcare and medical insurance claims processing solutions in the Philippines will help you empower your business to create accurate bills and get paid swiftly, ensuring a regular inflow of revenues to your business.

    Thailand

    Give the core functions of your business the boost they need by outsourcing claims processing services to a professional company like Fusion. This will help you improve core competencies and streamline your revenues.

    Indonesia

    Fusion’s professional and industry-leading claims processing solutions will help you submit and process insurance claims in bulk, ensuring that your business in Indonesia and other Asian countries can generate massive revenues.

    United States

    Looking for a professional company that offers competent outsourcing medical claims processing in the USA? Look no further! Fusion’s customized solutions are just what you need for your healthcare business in the USA.

    Canada

    With Fusion’s massive global presence, you can now enjoy incredible consistency with your claims processing requirements, enabling your healthcare business in Canada to get a high success rate and maximize outcomes.

    El Salvador

    Our HIPAA-compliant healthcare and medical claims processing services will help you get maximum settlements and payouts without the risk of compliance failures leading to financial and other industry-specific sanctions.

    Jamaica

    Fusion is an industry leader in delivering competent insurance claims processing solutions and can greatly benefit your business in Jamaica by ensuring maximum settlements to create a regular inflow of business revenues.

    Colombia

    Maximize the revenue-generating potential of your healthcare and medical business in Colombia with professional insurance claims processing services from an industry leader with over three decades of experience.

    Mexico

    Fusion’s superior-quality healthcare insurance claims processing services will enable you to relieve the additional burden of non-core activities off of your staff and empower them to focus on core business competencies.

    FAQ's

    FAQ's

    Why do you need claims process outsourcing services for your healthcare business?

    Managing healthcare and medical insurance claims submissions can be very tedious and tricky. Even a small mistake can amount to losses worth thousands of dollars. In addition, some mistakes can prove more costly if they violate industry regulations set forth by HIPAA and other regulatory compliances. These mistakes could lead to financial sanctions and create a negative reputation for your healthcare brand in the industry. Hence, the professional medical and healthcare claim processing services enable you to ensure compliant submission that will eventually maximize outcomes.

    Why should you opt for outsourcing medical claims processing in the USA?

    It has often been seen that hospitals, private clinics, and other medical facilities that choose to submit and process insurance claims in-house are unable to achieve a high success rate. Moreover, dedicating core staff to such non-core competencies can limit the impact of the professional experts employed by the business. In addition, it also takes out valuable resources from the business, which can eventually prove to be very costly for the healthcare brand. Hence, it is better to outsource healthcare and medical claim processing to a professional company with the resources and expertise for such tasks.

    Why should you opt for Fusion for your healthcare insurance claims processing requirements?

    Fusion has been in operations in the healthcare and medical industry for over three decades. Our extensive experience in the industry, combined with our comprehensive infrastructure, can offer a massive boost to your billing, insurance claims, and payment structure. In addition, our contact center solutions will also help you maintain healthy relationships with your customers, clients, vendors, and other business partners, developing a positive brand reputation in the industry. We will also help you maximize settlements and payments with our competent claims process outsourcing services that are customized to your business’s requirements.