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| Payer
Services |
Sales, Enrollment and Customer
Support
Tele/Mail/Fax
Support for Members and Business Associates
Claims Call Center
Coast to Coast support to claim queries for
providers and billing companies resolving issues
related to coding, medical necessities, and
patient eligibility. The center is equipped
with state of art equipment for Voice Logging,
Skill-based Routing, Intelligent Call Volume
Monitoring and CTI functions.
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Member
Enrollment and Eligibility
Our agents can remotely interact with county
and
prospective member to determine the eligibility,
enrollment process for commercial and federal
plans. The data collected through Insurance
agents are entered into system, updated and
skip-traced.
Member Support This blended
call center helps members and prospects with
Policy and eligibility related issues, supporting
online services that members use.
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 Software
Solutions and Data Security
R Systems provides high-end application integration
and custom solution design and development service
to global clientele. R Systems experts have
helped payer-end adjudication engines seamlessly
adapt to HIPAA compliant EDI transactions. All
our process outsourcing services are backed
up by the core Information Technology team to
accommodate multi-located multi-vendor systems,
integration of third party tools, web services
and impeccable digital security system. |
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