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In order to streamline enrollment, eligibility, provider contracting, reimbursement, premium billing, medical management, care management, claims adjudication, customer service, and reporting processes, a rules-based auto-adjudication software system is developed.
To further assist health plans, BPaaS offers administrative staffing services. Providers can check on the status of their members' eligibility, their claims, their demographic information, and their authorizations.
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