Third Party Claims Administrative Services
Overview

The ABCT Difference

  • Eliminate burden of handling loads of paper
  • Cost Savings of 40-60%
  • Unique process guarantees over 99.5% accuracy
  • Easy to do business with
  • Variable cost per claim and/or per member
  • HIPAA Compliance

Are you being overburdened by pended and unresolved claims?

Claims pended for longer durations increase risk of your organization for health-plan non-compliance, increased support call volume, and lower customer satisfaction.
ABCT Claims Adjudication services utilize claims professionals who are trained on multiple adjudication platforms and plan designs.  Our Adjudicators have knowledge of medical and dental terminology, coding and are analytical problem solvers.  New adjudicators are trained in an intensive program covering the U.S. healthcare industry and claims adjudication.  Our claims adjudicators also go through client specific training to learn your insurance plans, systems and claim types.

ABCT brings you a whole variety of health insurance claims processing solutions to help you manage your claims efficiently.  We bring our vast experience of over 25 years of claims administration.


Key Features

  • Accurately resolve pended claims using your guidelines, state and federal regulations, and using specific health plan criteria.
  • Review attachments and documentation which are received with the claim and utilize that information for adjudication.
  • Correct invalid information and/or enter missing information, so that pended claims are released on a timely basis from your system.
  • Health Plans and members always have access to a dedicated 1-800 Claims Hotline.  Our Claims Representatives also spend time paying and adjudicating claims, they are usually able to help callers immediately with any issues while the caller is still on the phone.

Key Benefits

  • Significant Cost Savings – Our Claims Adjudication services provide savings of approximately 40-60% compared to your in-house staff.
  • Better Accuracy – Our Claims Adjudicators thoroughly review each claim and attachments, resulting in higher accuracy and better compliance with your and health plan guidelines.
  • Improved Customer Satisfaction – Pended claims are resolved on a timely basis resulting in higher customer satisfaction and better plan compliance.