With HGS Healthcare, up to 80% of claims can be processed automatically. Our claims team works to continuously improve automatic processes, while also preparing to handle the unusual claims – the exceptions.
Our claims specialists train for an average of six months. They are fully equipped to handle rework and the 20% of claims that require a complete review and application of benefits, pre-authorization decisions, and contractual carve-outs.
We take a “can do” approach to claims, as we aim to provide value, not just metrics. We proactively flag pre- and post-pay deficiencies so they may be investigated to avoid further issues.