Claims Management Overview

Of course, scanning and data conversion are only the first steps. Once a claim has been scanned, a wide variety of editing is critical to maintain acceptable processing times. Smart Data has developed simple solutions to even your toughest editing challenges. We provide all types of edits, matching, duplicate checking, and real time reporting to help you stay on top of all of your claims-related workflows.

 

Smart Data provides a comprehensive range of claims management, from mailroom and data capture services to editing, provider file matching and eligibility confirmation. Once data formats are standardized, we automate EDI routing to make sure your claims are sent directly to your trading partners. Along the way, our customers can quickly and easily access data, run reports, and communicate through our industry-leading user interfaces and portals. From start to finish, trust Smart Data to make the process simple.

At Smart Data, we know that every payer and provider has a unique configuration of requirements. That’s why we pride ourselves on customizing our solutions for every client, providing an unparalleled level of personalized service. Once our solutions are implemented, our clients are often surprised at how easy it was to improve quality, reduce turn around time, and lower bottom line costs.

Complete Claims Management

Of course, scanning and data conversion are only the first steps. Once a claim has been scanned, a wide variety of editing is critical to maintain acceptable processing times. Smart Data has developed simple solutions to even your toughest editing challenges. We provide all types of edits, matching, duplicate checking, and real time reporting to help you stay on top of all of your claims-related workflows.

  • Clinical Editing
  • Provider File Matching
  • Provider Data Base Clean-Up
  • Eligibility Matching
  • Duplicate Checking
  • Submitter and End User Services
  • Extensive Reporting Capabilities
  • 5010 In-Site
  • Double Key Reconciliation
  • Eligibility and Claim Form Return
  • Pre-Adjudication Edits
  • Medicare MedSup Cross Connect
  • Mandatory Insurer Reporting (MIR) 
  • Portals