Health Insurance Claim Processing
Health Insurance Claim Processing
Accelerate Payments with End-to-End Claim Processing
At Mayon Healthcare Solutions (MHS), we provide comprehensive health insurance claim processing services that ensure timely and accurate reimbursements for your practice. Whether you’re dealing with in-network (cashless) or out-of-network (reimbursement) claims, our team manages the entire process — from claim generation to final payment — with precision and compliance.
We take the burden off your staff, reduce delays, and help you maintain a healthy revenue cycle.
Our Claim Processing Workflow Includes:
- Claim Initiation
We begin by collecting all necessary patient and treatment information from your EHR or encounter notes. - Claim Form Preparation
Our billing specialists prepare accurate claims using ICD, CPT, and HCPCS codes based on your specialty and services rendered. - Document Collection
Supporting documents such as procedure notes, lab results, prescriptions, and invoices are gathered and verified for completeness. - Cashless (In-Network) Claims
For cashless treatments, we handle pre-authorization requests, communicate with insurers, and submit final bills for direct payment to your practice. - Reimbursement (Out-of-Network) Claims
For reimbursement cases, we compile and submit a complete claim package to the insurer for payment to the patient or provider. - ERA & EOB Posting
Payments received are posted into your system with proper allocation of adjustments, deductibles, co-insurance, and patient responsibility. - Claim Monitoring & Follow-Up
We track each claim until it’s fully resolved. Denials are addressed immediately and corrected claims or appeals are submitted promptly. - Appeals & Escalation
Our team handles complex appeals, including documentation for medical necessity and payer-specific resubmission protocols.
Why Choose MHS for Claim Processing?
- Over 25 years of experience in U.S. healthcare billing
- Deep knowledge of payer guidelines, policies, and documentation requirements
- HIPAA-compliant systems and workflows
- Accurate coding and timely claim submission
- Dedicated claim tracking and denial resolution teams
- Faster turnaround and improved first-pass acceptance rates
Benefits to Your Practice
- Improved cash flow and reduced days in AR
- Fewer claim denials and payment delays
- Reduced staff burden and administrative costs
- Complete visibility into claim status and collections
- Increased patient satisfaction through transparent billing
Let MHS Handle Your Claims — End to End
With Mayon Healthcare Solutions, you get a reliable partner who manages the entire insurance claim process from start to finish. Whether you’re a single provider or a multi-specialty group, our goal is to maximize your reimbursements and streamline your billing cycle.