Audit OP and IP claims on a daily basis based on DHA guidelines and ensure that it is delivered with appropriate CPT and Diagnosis codes.
Confirmation of procedure codes for insurance Pre-approvals.
Review the OT summary immediately after the surgery for any revision of the procedure codes (Eg:- Addition of Service, Alteration in the procedure code).
Validation of Discharge Summary at the time of Discharge.
Analyzing the IP claims before discharge if final bill is needed.
If some changes have to be done during claim submission and XML generation, the concerned department is informed through an email.
