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Claims
Processing
Claims
are adjudicated automatically by our system. Our
system performs automated data checks for the
following items:
- Eligibility
of insured
- Eligibility
of charge for covered services
- Eligibility
of provider and identification of network providers
- Relationship
of charge to R&C geographically specific)
- Satisfaction
of deductible and/or stop-loss
- Application
of Contractual payment rates
- Application
of appropriate co-insurance or incentive co-insurance
features
- Application
of COB
- Application
of subrogation (e.g., workers' compensation,
no-fault provision, etc.) where appropriate
- Application
of Medicare Documentation
- Application
or verification of required pre-certifications.
Our
system is capable of identifying and separating
into individual data records (by claimant), multiple
practitioner visits or facility stays which can
been "batched" together by a provider
and submitted as a single claim.
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Island Group Administration,
Inc.
1-800-926-2306
3 Toilsome Lane
East Hampton, NY 11937
Ph: (631) 324-2306 • Fax: (631)324-7021
Designed
and Hosted by Vision
Marketing
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