At BMS Infosolution Software Technology, we offer end-to-end Claims Management solutions tailored specifically for healthcare payers, insurance companies, and TPAs (Third-Party Administrators). Our services are designed to streamline the lifecycle of medical claims—from intake and adjudication to payment and denial resolution—ensuring faster processing and reduced administrative costs.
We utilize advanced automation, data validation tools, and payer rule engines to minimize errors, reduce claim rework, and ensure regulatory compliance. Our team is skilled in managing both paper-based and electronic claims (EDI), ensuring accurate benefits processing, proper coding validation, and real-time status tracking. Whether you need support for commercial, Medicare, or Medicaid plans, we provide scalable solutions that align with payer-specific workflows.
By partnering with BMS Infosolution, healthcare payers benefit from improved claims turnaround times, enhanced provider satisfaction, and significant cost savings. Our technology-driven claims management process reduces leakage, flags potential fraud, and maintains compliance with HIPAA, CMS, and payer-specific guidelines—ultimately helping payers maintain financial health and operational excellence.
Automated Claims Adjudication – Streamlined validation, processing, and payment using intelligent automation.Regulatory Compliance – Ensures adherence to HIPAA, CMS, and payer-specific rules and standards.Denial Management & Appeals – Identifies claim issues early and manages appeals efficiently.Real-Time Claims Tracking – Monitor claim statuses through dashboards and alerts for transparency.Fraud Detection & Risk Analytics – Analyze claims data to detect anomalies and reduce overpayments.