Claims Processing

• Management team with 20 years of claim-capture experience.

•  Experience working with the leading health insurance companies.
•  Experience working with the leading worker’s compensation companies.
•  Experience processing more than 150,000 claims and bills per day.

• Demonstrated ability to increase auto-adjudication rates.
• Client-site or MetaSource-site mail prep, batching, and scanning.
• Worldwide data entry options.
• Integrated OCR solutions.
• Database matching typically to Provider and Subscriber databases to reduce costs, increase accuracy, and improve auto-adjudication rates.
• Claim image storage and retrieval.

MetaSource prides itself on delivering accuracy that meets or exceeds clients’ needs; but reduced adjudication costs are equally important to our clients. We partner with our clients and produce solutions that improve adjudication rates to as high as 98% by incorporating edits, databases, and other techniques to improve ingestion of data. Our most successful partnerships are formed when we aggressively reduce data entry costs while also increasing auto-adjudication rates.

Claim Forms Experience:

• HCFA 1500 single,
• HCFA 1500 single w/ attachments, 
• HCFA 1500 multi-sheet, 
• HCFA 1500 multi-sheet with attachments,
• HCFA 1450 (UB92's)
• EOMB's, 
• dental forms, 
• enrollments, 
• worker’s comp bills, and 
• non-standard medical documents

Some of the firms managed by our team now and in the past include:

• AIG Claim Services
• Anthem BCBS (OH, IN, KY)
• Banner Health (AZ)
• California BCBS (CA)
• CompBenefits
• Fallon (MA)
• First Option Health Plan (NJ)
• Harvard Pilgrim (MA)
• Intergroup (AZ)
• Lakeside Medical (CA)
• Oxford Health Plans (NH)
• Pacificare (CA)
• PMI Delta Dental
• Prudential (TX)
• Southwest Administrators
• United Health Plans (CA)
• Verti Health (CA)