Estimating conservatively, at least 30% of staff time is wasted due to missing or incorrect details. Using information derived from the post-audit analysis of the data, we set up custom workflows to sanitize the data with surgical precision – data is formatted as per cultural and legal conventions, content is assiduously checked for accuracy against known errors, duplicates are weeded out, and inconsistencies are ironed out.

After this, the data is formatted as per the required conventions and cross checked for accuracy with respect to coding, eligibility, pricing, documentation, member photograph mapping, and so on.

In order to guarantee precision at the time of entry, incoming data is checked against sets of customizable criteria – both industry-specific and client-specific – such as in the case of renewed policies, the member list is reconciled with last year's records. Known errors and logical inconsistencies – such as incorrectly matched photographs, incorrect demographics of the member for a particular location, and so on – are detected and resolved.

Checks also include Cardinality, Cross-system Consistency, Format, and Presence, among many others. Users entering data are helped by valid suggestions for open ended fields and are prevented from inadvertent errors by selectable choices for restrictive fields.

All captured member data such as name, age, policy number, benefits, plan period, and so on, having been thoroughly cleansed and validated, error-free membership cards can be swiftly prepared and issued as and when necessary – either in batches or on demand – as in the case of renewal or loss of card. IMTS's regular audit checks ensure integrity of member data vis-à-vis the pertaining benefit plans, thus preventing untoward incidents while simultaneously accelerating workflows.

As can be expected, IMTS's highly customizable interfaces empower you to exercise fine-grained control over all your member data stored in our highly secure environment – over the entire period of retention stipulated by the relevant Authorities. We enable you to access your data in a variety of formats such as flat file CSV, MS Excel, and/or XML – which can then be used for full compliance with the reporting requirements of the Health Authority of Abu Dhabi or the Dubai Health Authority (DHA) in the form of Person Registers or any other regulatory body.

Tight control enables you to precisely align rights and access permissions with each user's role, in turn, preventing untoward incidents while simultaneously accelerating workflows.

A niche service, which can only be performed by specialized professionals such as those of IMTS's dedicated team of doctors with dual expertise in medicine and insurance, the preparation of benefit plans is crucial to the speedy and accurate processing of claims and pre-authorization, as well as to the smooth functioning of the help desk and the call center.

Proficient in the preparation of benefit plans via software, including outsourced solutions such as Pharmacy Benefit Management (PBM), Eclaims, and others, our team helps drive down the costs and risks of benefits administration for insurance companies, TPAs, and Corporations.

Whether client is an Insurer, a Medical Service Provider, a Third Party Administrator, or a Corporation, IMTS can access/receive claims directly via FTP, direct download, or Eclaims. IMTS can also access and process claims scanned by a high resolution scanner at client's site.

Our aim is to facilitate precise control and close monitoring of claims funding processes by providing comprehensive claims management services including data entry, complete evaluation of all claims and adjudication.

The importance of consistently accurate coding analysis cannot be overstated – a Medical Service Provider could very well lose large amounts of revenue due to elevated claim rejection rates, and an Insurer or TPA could suffer hefty losses due to unnecessary payments.

Further tangible losses are the expenses incurred by all parties in following up on payments and in repeat processing of payment requests. Some losses are intangible, such as the totally unnecessary stress, frustration caused and friction amongst parties involved.

By eliminating losses, keeping down costs, and saving time, IMTS plays a major role in amplifying ROI as well as in minimizing unnecessary stress.

Utilizing the convenience of modern electronic reporting has truly accelerated the adjudication of claims in many regions all over the world, including the MENA region. Even so, IMTS maintains the capacity to work not only with Eclaims but also with paper claims, capturing every required piece of information from claim forms in order to provide fully electronic reporting of the information.

And, in order to accurately & efficiently decode provider claims on behalf of Insurers and TPAs, our large team of expert coders, processors, and analysts maintains, both personally and organizationally, comprehensive knowledge of all types of medical coding – including ICD-9, ICD-10, CPT, DRG, Dental codes, Drug codes and so on.

One of IMTS's core competencies is the quick adjudication of claims, accelerated to the edge of what can be delivered by both technology and human effort. At IMTS, automation performs nearly every part of every process antecedent to and subsequent to this step – except this crux, which necessitates human intervention.

Each claim is thoroughly checked by our cherry-picked team of medical professionals who are specialized in General Medicine, Pharmacy, Dentistry, Nursing, Physiotherapy, and so on.

Based on the specific terms and conditions of the policy, the adjudication team decides whether the claim is to be cleared for payment, rejected, or kept on hold pending further clarification.

Further, by proactively interfacing with and informing each party on behalf of the others, we at IMTS ensure that the least amount of time is expended, especially due to missing or incorrectly matching documentation.

Subsequent to the medical adjudication process and prior to officially communicating the decision, IMTS's proprietary software examines every claim in order to identify any remaining non-compliant claims. And because each Insurer or TPA has its own internal guidelines, our software can be finely tuned & customized to conduct precise audit checks that never fail in identifying non-compliance.

This is to the benefit of all parties – the Insurer or TPA, the Medical Service Provider, and the Member – because by ensuring all-round compliance, losses are minimized and, consequently, ROI is amplified.

IMTS doggedly follows up for every non-compliant claim using specialized IT tools and promptly communicating with members, providers and payers –while making every effort to minimize TAT.

Our continuous & comprehensive medical & technical support enables your teams to satisfactorily resolve every non-compliant claim.