Health Care

Medical Billing Solutions


Our experience includes integration with insurance providers, developing HIPAA-compliant solutions that facilitate claims processing, and assist with accounting and reporting.

INTEGRATION WITH CLEARING HOUSES AND INSURANCE PROVIDERS

There are over 2,000 insurance providers in the U.S. today, some of which operate nationally while others are limited to a single state. Not all insurance providers allow access to their client base, and those who do have various interfaces that can make it difficult to quickly check the validity of a patient’s insurance plan. It is not surprising that between thirty and forty percent of all claims are returned to hospitals unpaid. Clearing houses help reduce these risks, as they offer a uniform interface and regularly updated information that makes it easier to determine whether the patient has an insurance plan, the level of benefits and the responsible payee.

Quintix has solid experience in building software solutions that are tightly integrated with a variety of clearinghouses and thousands of insurance providers, including Aetna, Blue Cross, Blue Shield, Medicare, Medicaid, etc. Our expertise covers all EDI transactions for implementing:

  • Eligibility and benefits verification, in real-time or by batch
  • Claims submission and status inquiry
  • Paper claims
  • Payments and transactions management
  • Patients statements generation and management
  • Bi-directional interchange

SUPERBILL

To help our clients make the billing process more efficient, we simplify use of the Superbill form, which assigns a unique CPT code to each service, procedure or a lab test. With the Superbill, all services administered to a patient during a visit can be represented by a set of CPT codes, which are sent to a billing system that decodes them and creates a bill for the patient or his insurance provider. Quintix has broad experience in creating Superbill databases.