Insurance Support Services That Make a Difference
Take advantage of our expert team, refined process and robust technology by outsourcing your claims auditing or adjudication process to us. Claims auditing and adjudication can be time consuming which results in unclear fixed costs; we can help on a variable cost basis. Because we can both retrieve and review medical records, you don’t have to spend any coordination time between departments or vendors. We are the only team you need.
Our veteran experts and medical personnel are well versed in both HIPAA and HITECH rules and limitations and have a streamlined process for getting the records you need in record time.
"We don't just talk to [our clients] once. We stay in contact with them. Every 14 days, even if we don't have an update, we still contact them. That's one thing that really makes us stand out."
Vice President of Intake and Sales
How We Can Help
Claims Adjusting and Adjudicating:
Better with Technology
Leverage the power of our technology. Our in-house development team can integrate with your system or receive data based on your needs. We work to make the process easy for your team with regular and detailed reporting.
Cut Your Timeline by Half
We can condense the amount of time it takes to complete the medical records evaluation to 72 hours or less. Speedier medical records evaluation turnaround time means faster decision making.
Better manage your risk and claims in 3 proven steps
Medical Records Digitization
START WITH THE DATA
We start by collecting and organizing the available data in our fully encrypted, cloud based technology platform. We apply Optical Character Recognition (OCR) software to the records to help better identify keywords and phrases. Built into our process is a comprehensive methodology for efficient prioritizing. The power of our process is the data sharing from beginning to end. Some insurance carriers get two companies, one for retrieval and one for review. But with Smart Legal Solutions LLC, you don’t have to coordinate two teams. Our teams are in regular real-time communication, which continually improves our process and lowers your overhead and general costs.
Medical Record Evaluation
THOROUGH AND COMPLETE ANALYSIS
Our records review team has decades of experience analyzing all kinds of medical documents -- including hospital stays, primary care provider files, prescriber records, pharmacy history and specialists’ records. Our skilled reviewers provide a summary that is digitized and OCR searchable. We also add the critical element of a qualified nurse review, which often turns up additional information that may not be obvious or identifiable by non-medical personnel. That information may prove the claim – or disprove it. Having a physician, nurse and/or pharmacist evaluate case details and medical records and provide a thorough analysis can really help insurance carriers get to the bottom line.
COMPREHENSIVE QA REVIEW
Built within our process is a two tier quality assurance review. Whereby a second team of experienced healthcare professions perform a final review to verify the findings. Through this deep focus on quality, our results are consistently accurate and thorough. Through technology we manage this work efficiently to maximize review time. By applying our two tier review process to claims auditing our customers can arrive at the best decision faster.Let us show you how we work and what we can do. Give us a call or fill out the form on this page today and we will help you with a review!