
CLAIMS
MANAGEMENT
With over 15 years collective expertise in handling medical claims, OTH has become a proven specialist in:
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Complex Claims Management
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Cost Containment using Medicare and Usual Customary and Rates
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US and International Claims Review, Auditing and Adjudication
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Claims negotiations and settlements
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Guaranteeing full transparency, OTH has earned the complete trust of our clients by providing a responsive claims customer service experience that ensures all partners are well informed at all times.

COMPLEX
CLAIMS
MANAGEMENT
Our Well-Seasoned Claims Management Team consisting of Medical Professionals, Veteran Claims Adjudicators and Negotiation experts work synergistic-ally to:
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Detect and prevent Fraud, Over-utilization and Unethical practices
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Perform Medical Reviews that ensure all billing codes are appropriate and accurate
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Secure maximum savings using:
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Direct negotiations with Providers from our wide network
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Our Unique Relationships with Provider International /Business Offices
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CLAIMS
ADMINISTRATION: REVIEW, AUDITING,
ADJUDICATION
Whether it is a straightforward, simple claim or the most highly complex medical claim, OTH guarantees swift and accurate processing and payment.
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Our Claims Administration Team assures this by providing our Clients with services that include:
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Timely Payment
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Claims Adjudication & Bill Review/Editing
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Expert handling of US and International Claims
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Expedited & tailored resolutions to any escalated matter
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A dedicated authority that assures Coding Modifier Fidelity, who works with and educates Providers on Billing Method best
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An assigned Pre/Post Account Payment Reconciliation expert ensuring report and payment integrity

CLAIMS NEGOTIATIONS
AND
SETTLEMENTS
Regardless of the situation, OTH's Team of Negotiation experts always find a solution that secures superior savings for our Clients when compared to industry standards. Our Team will:
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Acquire Signed Agreements & Settlements that lock in savings
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Work with our Clients to inform them of their options so they can make the final decision
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Analyze bills and Utilize benchmarks such as Medicare+ and relevant cost data to ensure our performance compared to that of industry standards
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Engage in direct negotiations with providers for high-dollar claims