Medical Claims and Encounter Processing Services

Medical Claims and Encounter Processing Services

We always handle medical backend tasks like claims and encounter processing with 98% accuracy. Get claims processing experts who work at tight schedules at nominal rates starting from $1280/month

Is your need for claiming medical bills getting in your way of caring for your loved one? Are you feeling the burden of self-application of medical claims and dealing with the cumbersome encounter processing system? Handling the minutiae of medical claims can be tedious and complicated especially when you need to focus your time and attention on patient care.

With our extensive experience, we at Outsource2india dedicate ourselves to not only making this an error-free and smooth process but ensuring that all your claims are settled on time. Our expert teams are here to resolve all your queries and explain all the details in an understandable manner thus keeping you informed about the entire process. Outsourcing medical claims and encounter processing services has never been simpler.

Medical Claims and Encounter Processing Services We Offer

Over the last 24 years, Outsource2india, which is undoubtedly the best medical claims and encounter processing service provider in India, smoothly and efficiently handles medical claims and encounter processing. Our medical claims and encounter processing services include -

  1. Data Entry for Medical Claims and Encounter Processing

    Firstly, we provide you with the list of documents required by your insurance company to begin with the claims process. Here we acquire all patient information, consulting physician details, and all code sets which are then meticulously entered into our billing software. All data is systematically compiled and submitted electronically. A hard copy of the medical/encounter claims can be obtained upon request.

  2. Medical Claims Authentication

    We conduct stringent checks to ensure that all documents, bills, and invoices handed over to us are valid. Any medical claims and encounters submitted, if not in accordance with the billing system, will be returned to you with a complete explanation of the missing or incomplete information. We identify the circumstances that could delay the claim process and help you with tackling the same. Kindly note that any falsified information leads to the cancellation of the claim process.

  3. Medical Claims Data Processing

    All information is cross-checked before processing. We process all documentation in accordance with the protocol of the insurance company. Claims/encounters that pass the editing process are then translated to HIPAA-compliant ANSI format. This is followed by obtaining your signature on the final report before sending it across to the insurance company.

  4. Review of Medical Claims and Encounter Processing

    The Encounter Data Records (EDRs) and Chart Review Records (CRRs) should comply with the submission policies. All accepted and rejected claims are closely reviewed by us. We are equipped with the complete knowledge of Medicare and Medicaid payment regulations as well.

  5. Medical Claims and Encounter Processing Resubmissions

    Claims that are not compliant are sent back for the necessary corrections. In the case of claims rejection, we make the resubmissions as requested. In cases of claim denials (these cases cannot be resubmitted for assessment), we review the cause of refusal and accordingly make an appeal requesting reconsideration. Once approved, we put in a fresh application.

  6. Medical Claims Administrative Support

    Our team has strong verbal and written communication skills. We provide complete assistance for claim approval. We offer help with regards to any missing data. We contact the competent authorities to obtain duplicate copies of any bills or prescriptions in case of any missing information.

  7. Medical Claims/Encounters Data Indexing

    It includes collating and storing data such as the patient's demographic, EOBs, health insurance information, and treatment information in a systematic matter allowing for easy retrieval later. This helps is quick assessments in case of requirement of any healthcare documents in the future.

  8. Medical Claims Maintenance

    Our staff pays attention to detail. Every submission is kept confidential and maintained in an orderly manner. We can be approached at any stage, without any hesitation, for a duplicate copy of the medical and or/encounter claim.

  9. Explanation of Benefits (EOBs)

    We intimate you of the medical expense covered by the health care/insurance provider as what part of the expense if need be, is your responsibility. We give complete details on the deductible or a co-pay that needs to be taken care of.

  10. Accounting Support for Medical Claims

    Our staff cross-checks all the financial details reported to us by the insurance company. We ensure that you have the advantage of acquiring maximum pay-out from your health care provider.

  11. Online Tracking of Claims Application

    You will be notified at every stage of the progress of your application. This can be assessed by you at any moment.

Medical Claims and Encounter Processing Service - Our Process

Outsource medical claims and encounter processing services to us for error-free process and encounter claims. You can reach out to us with any of your doubts, queries, and concerns at any time. You can rely on our team for help with all future assessments without any hassles. In the case of switching insurance companies, we help you decide in selecting the one best suited to your needs. The assessment of all claims is done in a strict manner. The methodology followed by us for medical claims is as follows -


01. Data Accumulation and Entry

All valid patient information, consulting physician details, CPT and ICD codes are entered into the medical billing software


02. Authentication of Data

The documents are cross-checked for any errors


03. Adjudication

All claims are examined for accuracy


04. Explanation of Benefits (EOBs)

A detailed Explanation of Benefits is prepared


05. Submission of Claims

All claims are sent to the insurance company


06. Follow-ups

Timely follow-ups are done with the insurance company ensuring no delays in payments


07. Intimation of Claim Status

We inform you at every stage


08. Re-adjudication

Any claims denied are re-adjudicated and resubmitted for approval. Our encounter processing is a three-step process that includes -

  • Collect of Patient Data
  • Data Validation
  • Submission of processed report

Other Services You May Benefit From

Why Outsource Medical Claims and Encounter Processing Services to Outsource2india?

We are the best at what we do and opting our services will additionally provide you with the following -

  • Patient Data Security

    All patient data is secure with us. We strictly abide by our non-disclosure agreement wherein all information is kept confidential.

  • HIPAA Compliant

    All our results are in accordance with the Health Insurance Portability and Accountability Act (HIPAA) standard. We are known for our accurate report submission.

  • Cost-effective

    For the time and resources that you'd spend on the medical claims and encounter process, our services are a value for your money.

  • State-of-art Technology

    We possess the latest technology ensuring high-quality and flawless services. We can optimize claim management as well as to conduct predictive analyses to overcome potential denials.

  • Experienced Team

    All claims/ encounter processing will be handled by a team of experts who are trained to tackle and overcome hurdles pertaining to claims resubmission as well as claim denial.

  • Error-free Services

    Our unerring services entitle you to faster claims and encounter processing with a considerably low denial rate.

  • High-Quality Screening

    Our thorough scrutiny of all minute details ensures a higher success rate of the majority of claims and encounters.

  • Rapid Turnaround

    With our perfect workflow and swift handling, we are focused on providing you with all reimbursements within a stipulated timeframe.

  • Precision in Data Archiving and Extraction

    Every detail is systematically archived by us for future reference. We can retrieve patient files at any later date.

  • Claims Coding and Formats

    Extensive knowledge of CPT, HCPCS, revenue as well as other typical medical billing codes.

  • High-priority Service

    We priorities your claims based on the urgency and severity of the medical condition.

  • All-round Support

    Our services can be availed worldwide across all time zones. Our team can be contacted via chat, phone, e-mail or across our social media platforms 24/7 throughout the year to set you up with on-site consults and the required help.

Client Success Stories

O2I Helped the Client Streamline their Eligibility Verification Process

Helped the Client Streamline their Eligibility Verification Process

We offered pre-authorization, eligibility verification, and A/R follow-up for a top clinical billing consumer. The client's workflow was streamlined at reasonable rates.

Read more
O2I Provided Pharmacy Insurance & Medical Insurance Eligibility Services to a Telemedicine Provider

Provided Pharmacy & Medical Insurance Eligibility Services To A Telemedicine Provider

We provided eligibility verification services to a birth control telemedicine provider. Our teams coordinated the task to complete the process in a quick TAT.

Read more

Outsource Medical Claims and Encounter Processing Services to Outsource2india


Overall, I am pleased with the support. The response time and communication were fine. Knowledge of billing and claims was above the expectation. I recommend Outsource2india to those who are contemplating claims adjudication services from an experienced partner.

Founder, Medical Device Market Strategy and Reimbursement Company, Tustin, California More Testimonials »

Outsourcing medical claims and encounter processing services and adjudication services to Outsource2india will provide you with a higher and faster chance of obtaining your money at the earliest. Availing our services can help save valuable time and resources freeing you to focus on patient care. Outsourcing to O2I can give you the respite from running around and brainstorming on putting together a report for the insurance company. We are recognized for our accuracy and deliverance of maximum benefits. We have a high success rate of overturning denials putting us in a league beyond approach by our competitors.

Get in touch with Outsource2india today, the leading medical claims and encounter processing service provider. Choose us and be assured of the best medical claims and encounter processing services available online.

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