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Claims Processing

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Claims Processing

PDC has extensive expertise in processing of Commercial and Government Claims. PDC has a group of 20-40 operators well versed in HCFA and UB forms processing across many platforms. Our operator’s familiarity with State Medicaid Agency forms provides an added advantage. 


PDC offers two options for processing claims:
  1. Off-Line processing: Data capture of claim form information via PDC’s customized software system and then uploading the information to our client’s server.
  1. On-Line Processing: Direct connect to our client’s server, with proper secure permissions both on the client’s side and on PDC’s front end.  Data is captured from paper or image using the client’s software and then adjudicated real time.

The off-line option requires two levels of quality checks. Programmatic validations to alarm operators if they’ve captured data incorrectly and a verify check carried out by a different operator wherein data captured is compared to ensure high levels of accuracy.

On-line systems rarely offer a verification process. Thus, PDC has developed a Quality Control Process to monitor the consistency and accuracy of each operator and to ensure each operator adheres to stringent quality guidelines.


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