Healthcare call center services


Healthcare call center services

Expert call center agents

Netmark has a team of call center agents who are well-versed in 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.

Extensively trained

They have undergone extensive training to become the dedicated call center for the Health plan or Third Party Administrator (TPA). This training has equipped them with the knowledge and skills to handle any questions or concerns 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 and are trained in customer service best practices, including effective communication, problem-solving, and conflict resolution, to ensure that customers receive the highest level of service possible.

Across time zones

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 where they are located.

Customer service in several languages

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.

Well trained team for adjudication software platforms

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 keen on the nuances of different software platforms that allow them to identify and resolve issues, ensuring that claims are processed smoothly and without delay.

Claims expert

Each team will also have 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. They will also be able to navigate any complex issues and work to resolve them efficiently. This dedicated claims expert will serve as a valuable resource for the provider and beneficiary, ensuring that all claims are handled efficiently and effectively.

Netmark work with SLAs and TPAs

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 providing high-quality customer service.

Call centers assistance for 12 hours from 8 AM EST to 8 PM EST or long

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 for 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.

Frequently Asked Questions

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Frequently Asked Questions

Netmark prides itself on its deep expertise on multiple platforms like QNXT, AMISYS, FACETS, HSP among others. Netmark’s bench of expert examiners and appeal experts can truly help reduce claim inventory substantially in a matter of days.

All software pend a deny a percentage of claims while auto adjudicating a majority of claims. Backlogs and appeals are inevitable. Processing appeals are expensive as only the smartest and most experienced examiners can work on appeals. Netmark can offer extremely experienced appeal processors and offers a per-appeal processed price that helps the claims processing department stay within or under budget. Give us a call or email us at [email protected] for a quick conversation.

All software pend a deny a percentage of claims while auto adjudicating a majority of claims We offer…

Provider call centers manned by experienced adjudicators with knowledge of navigating complex adjudicating software

Experienced retired claim directors who can act as a SWAT team to handle any complex claims issue

Plan configuration – Am experienced team of claim configurators who can work with your actuaries and configure