Can you please give me a list of companies in the UK or USA that
process health insurance claims on behalf of insurance brokers.

 

Health Insurance brokers sell health insurance to the general public.

 

When a policy holder makes a claim, the claim needs to be 'processed'
by the broker.

 

Such processing may include checking that the claim falls within the
terms and conditions of the insurance policy, confirming and paying
amounts to health professionals and hospitals.

 

Brokers are able to outsource the processing of their clients' claims
to 3rd party insurance claim processing companies.

 

I would therefore like a list (over five would be acceptable) of 3rd
party insurance claim processing companies - ideally only those that
specialise in the processing of health insurance claims.

Hello josh_robb:

It is nice to answer the second question for you. I have located
reputable third party health insurance claim processors. Be assured
that all of these third party claim processor deal with a huge amount
of claims every year.

My list contains six such companies. Four of them deal primarily in
health insurance, while the remaining two are known to be one of the
largest third party claim processing companies in their geographical
area. Both of these companies serve the health insurance industry.
Here is the list for your review:

TELA
http://www.tela-usa.com/ServiceOffering.html
?T?la Sourcing provides offshore business process outsourcing (BPO)
services to U.S. healthcare organizations, including health plans,
TPAs/ASOs and other onshore service providers.?

Health Management Systems
http://www.hmsy.com
?HMS has served public healthcare programs and Medicaid managed care
plans in 30 states (see states shaded in red on the map below). And we
are the first vendor to generate more than $2 billion in third-party
revenue recoveries for our clients.?

Medical Insurance Claims Inc.
http://www.miconline.com
?Specializing in providing Long Term Care, Individual and Group Health
and Life Insurances. Medical Insurance Claims is your complete source
for health insurance services ranging from analyzing your coverage,
submitting your medical claims, to providing insurance products. We
are committed to meeting your needs through personal service,
expertise, and professionalism.?

Health Lambert Group
http://www.heathlambert.com
?Our traditions are founded on over a century of experience as a City
of London broker.? They are the seventh largest insurance and
reinsurance brokers in the world.

Helix UK Limited
http://www.sbjgroup.co.uk/helix_uk/company.html
?Helix UK Limited is our claims management and collection and training
company providing services to the insurance industry and its advisers.
Operating from its London office, Helix has over 30 staff. Helix UK
Limited is a wholly owned subsidiary of SBJ Group Limited.?

Financial Ombudsman Services
http://www.financial-ombudsman.org.uk
This is one of the largest companies in the UK that helps its clients
contest claims in a wide verity of areas.


Useful Search Strategy

<"Process health insurance claims">
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=%22process+health+insurance+claims%22&btnG=Google+Search

< Health insurance claims >
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=health+insurance+claims+&btnG=Google+Search

< Health insurance claims processing >
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&q=health+insurance+claims+processing&btnG=Google+Search

Please let me know if you are not satisfied. I will try my best to
fulfill your needs.

Sincerely,
Leader-ga.

Also try Trizetto which provides the software for outsourced claims
processing to several of the large managed care organizations and is
publicly traded (TZIX)
http://www.trizetto.com/Release/businessservices.asp.

A private competitor is Synertech which does the elctronic hosting,
but also has a large presence in manual back-office claims
adjudication.  www.synertechsystems.com