Service • Healthcare Claims Processing
Accurate Medical Claims
Data Processing
We capture and check HCFA, UB-04, Dental, and HIPAA electronic claim data with field level accuracy, so your billing pipeline never falls behind.
Claims Data Capture and Quality Checking
Before a claim ever reaches an insurer, someone has to get the data right. Names, codes, dates, provider details — every field has to match what's on the original document. Inspect our live claims extraction workbench below.
CMS-1500 Health Insurance Claim Form
Every document batch undergoes dual validation: automated algorithmic checks plus senior human specialist review.
| Field Key | Raw Scanned Value | Verified Structured Data | Status |
|---|---|---|---|
| Box 1a | MED-8924019-A | MED8924019A | Verified |
| Box 2 | HENDERSON, CLARA M. | Clara M. Henderson | Verified |
| Box 21A | M54.50 (Low back pain) | M54.50 | Verified |
| Box 24D | 99214 (Office Visit Lev 4) | 99214 | Verified |
| Box 24J | 1487293810 (Dr. R. Vance) | 1487293810 | Verified |
| Box 28 | $245.00 | 245.00 USD | Reconciled |
Supported Claim Formats
Rigorous field-by-field capture across paper, scanned, and EDI formats.
HCFA / CMS-1500
The standard claim form used by physicians, therapists, outpatient clinics, and most non-institutional providers. We capture and verify every field against the source document, from patient demographics to procedure codes.
UB-04
The uniform billing form used by hospitals and institutional providers. It carries 81 separate fields, and we check each one individually rather than relying on automated capture alone.
ADA Dental Claim
The standard form for reporting dental treatment to a benefit plan. We handle CDT code fields, patient and subscriber details, and the coverage checkboxes with the same field by field approach.
HIPAA Electronic Claims (837)
The standardized electronic claim transaction format. We process and validate this alongside the paper forms above so your data stays consistent across both formats.
Once a batch is done, it goes through a second pass of quality checking before it ever reaches you. We'd rather catch an error on our end than have it show up as a rejected claim on yours.
Full Medical Billing and Revenue Cycle Management
Data accuracy is the foundation. We're building toward the full billing pipeline on top of it; certified coding, claims submission, denial follow up, and patient billing, so clients can eventually hand us the entire process from one team.
What this will include:
- Medical coding (CPT and ICD-10) by certified coders
- Claims submission to insurance payers
- Denial management and follow up
- Patient billing and collections support
Our 4-Stage Claims Verification Pipeline
Rigorous two-pass field validation from intake to electronic clearinghouse transmission.
BAA & HIPAA Intake
Execute mutual Business Associate Agreements and establish end-to-end encrypted SFTP and EHR access tunnels.
Clearinghouse Mapping
Map provider NPIs, taxonomy codes, and payer clearinghouse rules against Availity, Change Healthcare, and Optum formats.
Double-Blind Verification
Every diagnostic CPT/ICD-10 code and modifier is independently checked by two specialists to eliminate rejectable errors.
EDI 837 Transmission
Clean batch export directly to your billing software with automated 835 remittance status reconciliation.
Our team scales with your volume. We maintain a trained bench ready to onboard fast, so growing claim volume never becomes a bottleneck on your end.
How We Handle Patient Data
Claim forms carry protected health information, and we treat that with the seriousness it requires. Our team follows HIPAA aware handling practices across every batch we process, and we can provide a signed Business Associate Agreement before any data changes hands.
Built Around Accuracy
Every batch goes through a two pass quality check before it reaches you. Our internal process is built around a 99%+ accuracy target on every claim type we handle, because a single wrong field is the difference between a paid claim and a rejected one.
This is the standard we hold every batch to, from the first one we process for you.