Americanmso

Claims

HealthSmart MSO claims

AmericanMso base img

HealthSmart MSO claims department provides efficient and prompt claims processing services for our contracted IPA’s, Managed Hospitals and provides claims adjudication in contract agreements. Our experienced staff at HealthSmart MSO is familiar with Medicare (CMS), Medi-Cal, Healthy Families and Commercial regulatory requirements, including claims timeliness guidelines to ensure claims are processed accordingly.
HealthSmart MSO is able to specifically customize clients payments based on the clients Health Plan contracts, provider contracts, member eligibility and member benefits.

Our state of the art claim system is able to log, adjudicate and pay claims. Our system automates most of the processing to allow greater accuracy and faster claim turnaround time. Our systems are able to read the information and automatically load it into our claims system.

HealthSmart MSO claims department provides efficient and prompt claims processing services for our contracted IPA’s, Managed Hospitals and provides claims adjudication in contract agreements. Our experienced staff at HealthSmart MSO is familiar with Medicare (CMS), Medi-Cal, Healthy Families and Commercial regulatory requirements, including claims timeliness guidelines to ensure claims are processed accordingly. HealthSmart MSO is able to specifically customize clients payments based on the clients Health Plan contracts, provider contracts, member eligibility and member benefits.

Our state of the art claim system is able to log, adjudicate and pay claims. Our system automates most of the processing to allow greater accuracy and faster claim turnaround time. Our systems are able to read the information and automatically load it into our claims system.

Our claims staff

AmericanMso base img

Our claims staff actively pursues recoveries on behalf of our clients. Most importantly, our Claims Department is committed to providing timely and courteous Customer Service Responses.

Our payment turnaround times consistently fall within accepted industry benchmarks, and we conduct back-end claims audits to avoid overpayment of claims and ensure that each claim is paid according to contracted rates. HealthSmart MSO supports in-house recovery procedures to identify and recover lost money on insured services, reinsurance, overpayments, Third-party liability, coordination of benefits, and retroactive terminations.

PremierOne Plus MSO’s claims department simplifies and make your claims processing prompt and efficient. All our staff are very experienced with Medicare, Medi-Cal, and Commercial regulatory requirements and time guidelines, simplifying and customizing claims processing. We provide flexible solutions that customize client payments based on each specific Health Plan contract, Provider Contract, member eligibility and member benefits.

claims image

Our MSO Claims Management System automates the claims submission and payment process by logging, adjudicating, and pay claims. Our systems allow you to submit claims electronically, through our Claims Submission web based platform, thus substantially reducing processing times. Providers can also review statuses and histories of their claims and payments.

Our MSO Claims Management System automates the claims submission and payment process by logging, adjudicating, and pay claims. Our systems allow you to submit claims electronically, through our Claims Submission web based platform, thus substantially reducing processing times. Providers can also review statuses and histories of their claims and payments.