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Somotsoft provides innovative Healthcare BPO solutions for claim processing and benefit administration. Somotsoft reduces claims processing costs and streamlines benefits administration operations to maximize productivity and profitability for healthcare TPAs, Independent Physician Associations (IPAs), hospitals, managed care networks, and self-insured employers. Somotsoft offers complete Healthcare BPO Services, including:

Data Entry
Somotsoft performs data entry for all HCFA 1500, UB92 (HCFA 1450), ADA Dental, Rx and prescription claims using a dual validation method to ensure 99%+ accuracy. Typical turnaround times for claims adjudication average 24 to 48 hours.

Somotsoft performs repricing for clients in a variety of methods, including going directly to third party repricing systems, or through ANSI 837 transactions.

Somotsoft claims examiners can log into client claims processing systems remotely using VPN, terminal services, or a variety of other remote protocols to perform claims adjudication directly on their system.

EDI Services
Somotsoft can receive claims sent in HIPAA-compliant ANSI 837 format, and convert and upload to clients in the Claims Manager importable format.

Advantages of Somotsoft
Reduce and control operating cost
Free up internal resources to focus on strategic outcomes
Reports provide immediate details about any aspect of your claim processing output - types of claims, payment amounts, provider costs, etc.

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