BPO Services

MDI NetworX offers business process out sourcing services (onshore & offshore) and IT services to the US healthcare providers and payers. MDI NetworX assists HMOs, TPAs, Insurance Payers, Medical Providers and MCOs to enhance operational efficiencies, streamline internal processes, which increases their overall competitiveness in the market. We provide services to meet customized requirements, covering the entire healthcare claim lifecycle. MDI NetworX empowers client to focus on their core activities by relieving them from efforts, labor management, operating costs and training costs leading to overall cost advantage.

MDI NetworX's C-Golem claims processing solution represents a compactly integrated with front-end claims process that deliverers EDI (4010 / 5010) or any other custom output. Our C-Golem significantly reduces administrative costs, improves auto-adjudication rates and reduces turnaround time. We have wide-ranging experience in converting all types of claims forms including CMS1500 and UB04 (Single / Multi / Attachment / COB), RX claims, Medicaid, Foreign claims, Super-bills, Dental and Vision claims to EDI (4010 / 5010) or custom output. MDI NetworX clients benefit from our wide range of services including front-end claim processing services, Claims Adjudication, Specialized Audit and Claim Scrubbing, Online Document Management System, software development and programming solutions. Our clients are very happy and satisfied with the quality, turnaround time, customer service, and continually increasing scope of services provide by us. Advanced technology and optimal resources have resulted in clients gaining significant efficiencies in their processes and achieving cost savings of 30-50%.

MDI NetworX provides the following business process outsourcing (BPO) services via onshore, offshore or blended shore delivery models:-

Claim Administration Services
  • Mailroom/Scanning
  • OCR/DE data capture
  • Paper to EDI conversion
  • PPO routing
  • Online Data Capture
  • Claim Adjudication
  • Specialized Audit
  • Claim Scrubbing
Specialty Services
  • Business Rules Configuration (QNXT, Facets)
  • Member Enrollment data entry
  • Flexible spending account (FSA) administration
  • Dental Claim administration
  • Vision Claim administration
  • Claim Adjustment
Provider Network Development & Management
  • Credentialing support
  • Provider / Member Database setup and Maintenance
Platform knowledge includes QNXT, FACETS, LuminX, MC400 etc.