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Medical And Dental Insurance Claims Processing
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SDD Global provides a full range of services to a growing consortium of medical and dental clinics to rapidly and cost-effectively assist them and their patients collect payments from health insurance companies.  We stand ready to expand our clientele to include other medical or dental associations, or individual clinics.

The Problem  
  • Clinic employees spend a significant amount of time performing such tasks as contacting health insurance companies by telephone and in writing, and completing innumerable forms.
  • Because such tasks are so time-consuming and burdensome, clinic staff often are unable to approach the situation pro-actively, which slows down payment recovery, and in turn weakens cash flow, sometimes irretrievably.
  • Front-office and other clinic personnel are distracted, and even annoyed, by dealing with difficult insurance company claims representatives, such that the clinic staff cannot offer the exceptional customer service that the clinics expect, and upon which the clinics pride themselves.
  • The health insurance companies already are relying on low-cost off-shore support, such that they are able to devote virtually endless person-hours to the task of placing roadblocks in the path of claim payments, in a manner that sometimes is no match for clinics who do not have similar resources
The Solution  

The solution is to transfer insurance payment recovery work offshore to SDD Global, saving time and cost, and increasing employee productivity and morale.  SDD Global’s executive personnel have extensive experience working with some of the largest insurance companies in the world, and in particular, experience with the transitioning of payment recovery operations to India.

SDD Global provides its clients with specifically designated, dedicated and highly trained personnel who can relieve busy clinics of all of their insurance payment recovery work, making all the necessary telephone calls and completing all the appropriate forms.  Our personnel closely monitor the insurance receivables and promptly make all follow-up calls when insurance payments are found to be overdue.  SDD Global pro-actively overcomes claim processing obstacles, such as the need for more patient insurance information.  At our clients’ election, we can have limited, secure access to their electronic databases to submit the necessary information, and only what is necessary, directly to the insurance companies for processing.

The Benefits  

The benefits of hiring SDD Global for payment recovery processing include, among other things, the following:

  • Dramatically increased and accelerated recovery of payments.
  • Substantially reduced operating costs, human resource costs, and recruitment and training expenses.
  • Improvement of service quality, productivity and enthusiasm among clinic staff, flowing from a much-increased ability to focus on patient care, and other important onshore services, which have been neglected due to the burdens of insurance payment recovery efforts.
  • Ability to receive and review status reports of claims daily, monthly, quarterly, annually, or otherwise as requested.
  • Assurance that SDD Global need not and will not contact or have any interaction with patients.

 
  • Entry of patient demographics

  • Inbuilt software process for protected health information to assure HIPAA compliance

  • Processing of charges for all specialties, following appropriate rules

  • Effective charge control measures, including hash-total matching or software-based batch control

  • Manual and electronic payment posting, with daily deposits balanced accurately

  • Manual processing of Explanation of Benefits (EOB) from insurance

  • Denials/rejections analysis

  • Low reports and denials sent to client on daily basis

  • Immediate handling of denials and sending of secondary claim reports on daily basis

  • Thorough and continuous accounts receivable follow-up

  • Identification of category/payer combinations to process the best collections first

  • Document management

  • Use of scanned images plus electronic demographic sheets

  • Accessing of information via server or directly from software screen

  • Internal quality assurance at every level

  • Addressing challenges of HIPAA while meeting client requirements
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