Claims Operations

MedPOINT’s Claims Operations Department is responsible for timely routing and proper adjudication of all claims to meet regulatory timeliness and payment guidelines established for each line of business. Business rules and standards for effective claims processing are continually established and approved by each of our clients.

MedPOINT uses EZ-CAP manual adjudication modules in conjunction with Virtual Examiner, Virtual Reporter and SymKey to log, audit and adjudicate claims.

Practitioners are encouraged to submit claims electronically through Office Ally or make special arrangements to use another clearinghouse. Paper claims are routed through ImageNet so the data can be converted for electronic inloading. Approximately, 75% of all providers are currently submitting electronically.