Healthcare BPO Services – Clinical, RCM & Support

Medical Triage

Our US-licensed nurses assess patient symptoms in real time to reduce unnecessary ambulance dispatches, lower patient costs, and ensure urgent calls are never missed.

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Utilization Management

We review treatment plans against clinical criteria to ensure medical necessity and reduce unnecessary costs.

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Clinical Review

Our team reviews patient records and care plans to ensure they meet clinical and regulatory standards.

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MD Review Support

We assist physicians in evaluating cases to enhance patient outcomes.

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Post-Decision Support

From follow-ups to referrals, we support the continuity of care after coverage decisions are made.

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Appeals and Grievances

Our team supports every step of the appeal, ensuring compliance and increasing chances of resolution.

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New Patient Sales

We engage with potential patients to drive conversion, supporting your growth goals from the first interaction.

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New Patient Intake

We gather and verify essential patient information upfront, accelerating the path to service.

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Order Follow-Up

Our team handles inquiries, resolves issues, and keeps patients informed, proactively tracking and confirming order statuses to boost patient satisfaction.

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Re-Order

We identify and engage eligible patients for timely reorder where nothing slips through the cracks protecting your recurring revenue.

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Retention

Our approach is personal, timely, and focused on uncovering barriers to retention, reducing churn to build lasting patient relationships.

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Customer Support

We manage patient inquiries across channels—calls, email, chat—with speed, clarity, and care resulting to improved response times, reduced escalations, and enhanced brand trust.

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Scheduling

We take ownership of appointment scheduling and confirmations—seamlessly integrating with your systems to minimize no-shows, prevent scheduling errors, and keep patient flow on track.

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Eligibility Verification

Our team verifies benefits accurately so patients and providers know what’s covered resulting to better patient experience, and faster reimbursement.

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Prior Authorization

We manage the full auth process so your staff can focus on patient care—not waiting on hold.

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Claims Submission

We prepare and submit claims with accuracy for cleaner claims, faster payments, and fewer back-and-forths with payers.

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Front End Rejections

We resolve rejected claims quickly by identifying root causes, fixing issues, and keeping revenue flowing without delays.

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Cash Posting

We close the loop on reimbursements and give you real-time visibility, freeing your team to focus on higher-value tasks.

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Denial Management

We handle denial analysis, appeal documentation, and timely follow-up so you spend less time chasing unresolved claims.

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Accounts Receivable Management

We actively follow up on unpaid claims to reduce aging and accelerate cash flow.

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Coding

Our certified coders ensure each claim is accurate, compliant, and audit-ready resulting to fewer delays and stronger payer relationships.

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Account Creation

We handle the setup of new accounts with speed and accuracy, ensuring a smoother intake process.

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Data Entry

Our team is trained in healthcare documentation standards to ensure compliance, minimizing errors and rework - helping keep your systems clean and up to date.

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Medical Criteria Validation

We review and validate medical documents against required criteria to support approvals and billings, ensuring documentation meets payer expectations.

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