Medical Billing Expert

Streamlined Insurance Claims Processing Services

Speed Track Insurance Claims Processing with Highly Customized Solutions

Providing Optimal Ways for Processing Insurance Claims

Processing health care insurance claims is an uphill task for healthcare providers. And during critical times, like that of a pandemic, the number of transactions can overwhelm your billing department. Improper management of insurance claims processing can lead to costly errors and even compliance violations. Delegating claims processing healthcare to a medical claims’ management company is the best available option for providers to save on money and time expended in managing the process and ensuring accuracy and compliance.

MedBillingExperts effectively integrates technology, experienced personnel, and flexibility to provide end-to-end medical insurance claims processing services. We understand that for every claim that is not closed on-time, the administrative costs incurred will go up. For that reason, we strive to reduce the open-to-close ratio for our clients. From our team of experienced domain experts to our established processes and from our global delivery centers to our modern claims management system, we ensure every claim is processed correctly for clearance at the very first submission.

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Help You
Minimize Claims

  • Organize front office process to verify patient eligibility accurately contact insurer for verifying coverage and policy changes
  • Automate billing tasks that are routine and repetitive. Some such tasks include issuing payment reminders, cross verifying medical codes etc.
  • Ensure multiple quality checks of files at different stages of the claims process. We also carry out regular audits of the QC process.
  • Track denials for at least 3 months to develop a baseline ratio of denials to charges and focus accordingly on claim form corrections
  • Be up to date with payer deadlines and process claims before the deadline. Establish a process to understand delays in claims submissions

Our medical insurance claims processing steps consist of the following

Review Claim Forms

Receive new claims check for eligibility and errors in coding and billing

Check for Payer Rules

Pre-adjudicate the claim to make it accurate and in keeping with payer guidelines

File Claims

File the processed claim with the insurance company and get claim status number


Review Denials

Receive and review denied claims and resubmit them for review

Follow up

Follow up with payers on resubmitted claims or wrong denials


Our Insurance Claims Processing Support Services Cover Your End-to-End Needs

Our health insurance claim process helps you to make your healthcare claims processing system more streamlined and better managed:

Eligibility Check

Checking patient eligibility is a critical part of our medical claims processing service. We carry it out meticulously to have a clear understanding of primary and secondary coverage details, out-of-network benefits, and patient’s payment obligations. Our streamlined eligibility check service helps our clients to eliminate all types of delays in insurance claims processing.

insurance claim processing eligibility checking
Billing and Reconciling of Accounts

Billing and Reconciling of Accounts

Our billing and reconciliation services help you to submit accurate claims and receive detailed reconciliation reports of billing data and payments from various payers. These reports provide a detailed break of the payments received, denied charges and outstanding bills. We review the reports and flag inconsistencies with the payer. We do regular follow ups till the issue gets settled.

Open-To-Close Claim Ratio

We assist our clients in reducing claims submission errors and, in the process, improve open-to-close claim ratio. We adopt best-of-the-breed techniques and technologies – fraud control technology, understanding of deep internal codes, automated systems for chosen areas – to ensure all types of errors in claims forms are identified and eliminated.

Open-To-Close Claim Ratio
Robust Quality Control

Robust Quality Control

We guarantee quality healthcare claims processing services by banking on system enhancements to streamline workflow, centralizing information to reduce touchpoints, and leveraging data analytics to take informed decisions. We have created well-defined workflows to ensure accurate and consistent results day-in and day-out.

Review Denial Decisions

At times, a payer may process a claim incorrectly. In such cases we get in touch with the insurance company to figure out why a claim was rejected. If after evaluating the denial reasons we believe it was processed incorrectly at the payer’s end, we write a formal appeal for a review seeking a reconsideration of their decision.

Review Denial Decisions

Our Specialties

Why we are an Industry Authority in Insurance Claims Processing Services

HIPAA Compliance

As a HIPAA compliant healthcare BPO service provider we follow standard transactions to improve claims management revenue cycle.

Extensive Training

Our team of claim processors are trained continuously to be up to date with the rules and regulations of third-party payers.

High Accuracy

The claim files undergo multi-level quality checks to ensure there is complete accuracy in information filed.

Rigorous Claim Audits

We carry out regular audits of our claims insurance process to identify procedural lapses and plug them to keep the process optimized.

Assured Data Security

Our healthcare insurance claims process is conducted through secure networks fortified by firewalls VPNs, SSLs, and advanced encryption techniques.

Advanced Technology

We deploy advanced claims processing tools and software to eliminate errors and ensure a quick turnaround.

How we Streamline Healthcare Insurance Claims Process

Meticulous Filings

We meticulously file claims after verifying patient eligibility, coverage status, and demographic information

Multiple Reviews

We carry out multiple reviews of the claims forms to ensure that primary and secondary insurance details and coding is accurate

Payer Rules

Our claims processing experts have updated knowledge of each payer requirements and process claims form accordingly.

Read What our Clients have to Say About Us

Roger Scudder Renowned Ambulance Service Provider, Texas

"We were facing huge claims mismanagement which was leading to denials. Soon our revenue loss began to mount to unprecedented levels. MedBillingExperts helped us find out that the main reasons for our denials were charge entry errors and erroneous information. We sought the help of MedBillingExperts and they helped us streamline the process in 2 months’ time. Our losses were completely reversed. I will always say the claims processing staff at the company are amazing! Every question I had, they responded on time. Now thanks to them we have a more stable process in place."



Dr Fritz General Manager, Reputed Cardiology Center, Washington

"Lack of resources and high volume of claims led to missing of deadlines in filing claims. Our inhouse processors had to deal with huge number of claims in a day and were overwhelmed with the workload. To top it, incoming claims continued to pile up.MedbillingExperts provided us with adequate number of staff to deal with our mounting problems. Their robust process ensured there was no erroneous claims submissions and no pile up of backlogs. Soon, we got full control over the claims filing process."


Health Insurance Claims Processing Through Our lens

Our Complete Analytics Process

Our Process

Our Health Insurance Claims Process

Go through the process diagram to understand how our end-to-end health insurance claims process is designed to help you get paid without any delays or denials.

The Importance of Healthcare Insurance Verification and Ways to Streamline It


The Importance of Healthcare Insurance Verification and Ways to Streamline It

Insurance verification is a critical part of the insurance claims process. This infographic takes you through all the major steps of insurance verification that can well be the founding stone to smooth claims processing.

View our infographic here
Know the Features that Make an Insurance Verification Tool Powerful and Reliable


Know the Features that Make an Insurance Verification Tool Powerful and Reliable

Insurance verification consists of several sequential steps, one of which is verifying patient eligibility. By relying on a patient eligibility verification tool, providers can make this task a lot easier. This blog throws light on the essential features that a verification tool must unmistakably have.

Read more info
Meeting Insurance Eligibility & Benefits Verification Challenge

Case Studies

Meeting Insurance Eligibility & Benefits Verification Challenge

We assisted Minnesota's largest medical billing and consulting service provider, working with over 100+ accounts (Clients/Doctors) across multiple specialties process, simplify the complex and time-consuming process of verifying patient insurance coverage.

Read case study to know more


Clean Claims On First Submission




HIPAA Compliance


Increase in Collections

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Our Healthcare Software Expertise

Software Tools We Use for Medical Billing and Coding Solutions