Claims Processing and Adjudication

Firstsource is a trusted BPO partner for leading healthcare payers, providing end to end healthcare claims processing and adjudication services, enabling them to save time and money while better serving their customers across the claims lifecycle.

Streamline your claims operations and increase efficiencies across the entire lifecycle

The cost of healthcare claims administration is rising exponentially along with growing demand for faster, error-free processing and payments, and a better overall customer experience. As paper claims, manual processes, and claim errors cost insurers billions of dollars annually, traditional approaches to claims processing and adjudication struggle to keep up. Meanwhile, every manually processed claim directly impacts a payer’s bottom line, and every incorrectly processed or wrongly denied claim adversely affects their Net Promoter Scores (NPS).

Firstsource helps payers save time and money, and better serve their members by increasing efficiencies across the entire claims lifecycle – from claims intake and processing, to final adjudication and payment. Our proprietary workflow technology, skilled adjudicators, and automated audit processes reduce turnaround time (TAT), increase processing quality and accuracy, and reduce backlogs—without the need for further capital investment.

Stay Ahead

Firstsource’s Claims Processing and Adjudication services help payers to more effectively:

  • Convert and reduce backlogs
  • Reduce cost per claim
  • Reprice claims, correct coding and coordinate benefits
  • Verify payments, service lines, members and providers
  • Manage claims processing peaks
  • Identify and analyse duplicate and bundled claims
  • Adjust claims, manage denials, and process appeals
  • Process a wide variety of claims across multiple plan types and platforms
  • Manage fund accounts such as FSAs, reimbursements, deductibles, co-pays and more

Why Firstsource?

"Leader" in the IAOP Outsourcing 100 List for 2017

This prestigious designation is granted only to the best and most disruptive BPO companies

Trusted by FTSE 100 & Fortune 500 companies

We believe in long term partnerships - over half of our clients have been with us for 7 years or longer

18,000+ people in 38 global delivery centers

We deliver 24/7 customer support aided by advanced analytics, RPA and cutting-edge technology

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Related Pages

Healthcare Claims Administration

For healthcare payers, we provide best-practice workflows, technology and support for efficient healthcare claim processing thereby delivering improved customer experience resulting in growth and increased revenue.

Enterprise Claims in the Cloud (BPaaS)

Firstsource automates your workflows, makes claims processing faster and more accurate, enables superior claims analytics and fraud protection and delivers superior customer care from our contact centers across the US.

Omnichannel Contact Center

Firstsource's omnichannel contact center solution is designed to help payers increase revenues, decrease their cost to serve, and improve their Net Promoter Scores (NPS).