Claims Processing (TPA Services)

More medically sophisticated than an Accounts Payable system, Ballymore’s claims processing services can generate savings and increase your productivity. We use comprehensive, HIPAA-compliant software — customized for the correctional health care environment — to adjudicate, process, and pay claims. Our state-of-the-art system automatically applies health care industry standards to review claims for duplicate charges, invalid codes, mutually exclusive procedures, and other potential cost drivers, thus:

• Protecting you from fraud and minimizing or eliminating overpayment;
• Improving your provider relations by minimizing claims processing time and generating industry standard forms and reports;
• Securely providing real-time access to information so your staff can respond to inquiries quickly and accurately;
• Allowing you to take advantage of flexible contract administration and complex provider reimbursement models.