Netmark Business Services provides Provider call centers to answer questions on claim status inquiry assistance to Providers. The goal is to greatly enhance Plan satisfaction and response speed to Providers. The center is staffed with agents who are very familiar with multiple adjudication platforms supervised by an expert during call hours (typically 8 AM EST TO 8 PM EST) to address any kind of complex Provider questions.
Netmark has a team of call center agents who are well-versed with the various adjudication systems. They are experts and know the intricacies of each system. They can assist customers with their inquiries and concerns related to these systems, navigate through the different adjudication processes, and provide accurate and efficient customer support. With their extensive experience and training, Netmark’s call center agents are equipped to handle various issues related to adjudication systems and can provide customers with the best possible service and support.
The team members have undergone extensive training to function like a dedicated call center for the Health Plan or Third Party Administrator (TPA). This training equips them with the knowledge and skills required to handle any questions or concerns that customers may have regarding their health coverage.
They are also trained in navigating the various systems and processes of the Health Plan or TPA, ensuring that they can provide accurate and efficient assistance to customers. The trainings include customer service best practices, effective communication, problem-solving, and conflict resolution skills, to ensure customers receive the highest level of service possible.
These centers can be staffed across different time zones, providing 24/7 efficient customer service. Customers will always have access to support and assistance regardless of their geographical locations.
Netmark offers a diverse range of services, one of which is providing agents fluent in multiple languages, including Spanish. We have a team of agents who can communicate effectively with Spanish-speaking customers and clients.
This aids businesses and organizations that have a large number of other language-speaking customers or clients. Netmark aims to bridge the language barrier and cater to the needs of a wider customer base.
Our agents thoroughly understand the process of examining claims and the intricacies of various adjudication software platforms.
They analyze and evaluate claims effectively and quickly, and accurately process and adjudicate claims, ensuring that they are handled efficiently and fairly.
They are quick on the nuances of different software platforms that allow them to identify and resolve issues, ensuring that claims are processed smoothly and without delay.
Each team has a dedicated claims specialist who can answer any difficult questions a healthcare provider or beneficiary may have. Our expert in the field of claims will be able to provide accurate and detailed information on time. This dedicated claims expert will serve as a valuable resource for the provider and beneficiary, ensuring that all claims, complex issues are handled efficiently and effectively.
Netmark can collaborate with Service-Level Agreements (SLAs), commonly used by health insurance plans, and TPAs for internal call centers. By working with these SLAs, Netmark ensures that our services align with the expectations of the health plans and TPAs and that the call center is equipped to provide high-quality customer service.
Most call centers are staffed for 12 hours a day, operating from 8:00 AM Eastern Standard Time (EST) to 8:00 PM Eastern Standard Time (EST). The call center is open for business during most of the working day, allowing customers to call in and receive assistance during working hours.
The long hours of operation allow flexibility for customers who may need to call in outside of traditional business hours. The extended hours also help to ensure that customer inquiries and concerns are addressed on time, reducing wait times and improving overall customer satisfaction.
Healthcare call center services involve understanding the complexities of each system. Netmark’s call center agents are equipped to handle various issues related to adjudication systems and can provide customers with the quickest possible response, service, and support.
Healthcare call center services provide a convenient and efficient way for providers to get the information they need, quickly and easily on a specific claim.
Most healthcare call centers offer a variety of services, including appointment scheduling and reminder calls, patient follow-up after hospital stays or treatments, prescription refills, and medical billing inquiries. There are also Provider call centers that only serve providers and answer questions related to claims.
A healthcare call center is a centralized facility where telephone operators answer incoming calls from patients, medical professionals, and other key stakeholders in the healthcare system. The call center serves as a communication hub where questions can be answered, appointments scheduled, and other patient needs to be addressed.
HEALTH PLAN AND TPA SERVICES
300 E Business Way,Suite 200, Cincinnati, OH 45241.
© 2024 All rights reserved.
300 E Business Way Suite 200 Cincinnati OH 45241
Business and Individual Tax Returns
Claim Adjudication for Health Plans
Medical Retreival and Review
We received your inquiry and we’ll bein touch with you shortly.