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TPA Services by Healthgrate

Medical & Insurance Review

Medical & Insurance Review

Billing

Billing


Resubmission Management

Resubmission Management

Denial Management

Denial Management

Recovery

Recovery


Reconciliation

Reconciliation


Decrease the chances of rejection, deduction and ensure early payment with
Healthgrate TPA.

Medical & Insurance reviews

Medical Billing is the process which is often considered tedious, but is most vital to every provider

Submission of claim

Submission of claim as per protocol & as per standardized codes (DRG)

Confirmation receipt

Confirmation receipt of co-payment



Issues or potential

Issues or potential errors on agreed tariffs are flagged before submission

Batches of e-claims

Batches of e-claims are submitted quickly & more frequently so as to reduce the billing cycle

Accounts receivable

Accounts receivable and denials are managed


Every legitimate payer denials

Every legitimate payer denials identified and corrected for future cycles

Experience seamless communication of data, complete automation of hospitals and patient monitoring systems with Healthgrate.

Reconciliation

Reconciliation of accounts – between what was billed by the provider & paid by payers following all submission & resubmission steps. The main objective is of achieving and maintaining the lowest rejection rate.

Complete analysis

Complete analysis of non- or partial payment against submitted claims
 

Re-process claims

Re-process claims with necessary changes and justifications and submit to the payer for re-evaluation

Review

Review the Tariff /Price list and contract terms with payer if rejection is related to the same

Complete review

Complete review of medical documents and provide medical justification to payers for services claimed

Bringing innovation in healthcare with futuristic technology and smart clinics solutions.