Payer Services

Determine Coverage. Reduce patient and eligibility related denials. Improve cash flow.

Automate and simplify operational tasks associated

Our Solutions

The face of healthcare is rapidly changing. Rising costs, healthcare reforms and rising consumerism are reshaping the industry today – providing new challenges and creating opportunities for payers to create a smarter, more efficient, consumer-focused healthcare system. These challenges require health plans to achieve a much greater level of operational efficiency to unlock cash for investments in the future while achieving a best-in-class operating model. Payers need to manage costs, provide quality care, and invest in new age processes and systems to grow and thrive.

Provider Data Management

Our data cleansing and Verification services (DCAV) brings consistency to the health plan’s provider data, is often necessary to bring consistency to health plan’s data.

Claims Processing

As a payer business process services provider, Atom Healthcare provides claims data entry resources who process claims with high degree of accuracy while adhering to turnaround times service levels.

Member Enrollment Services

Member enrollment, the first step in the Member Servicing cycle, is a critical business process that is often fraught with numerous errors and irregularities, due to paper-based, manual processing.

Claims Review and Contestation

Our expert team has a capability of performing the below services for Medicare Advantage as well as Medicare Advantage Prescription Drug plans

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