BPO:  Fax-to-EDI Services

þ      Submitters fax professional and dental claims to Payor or Tesia-PCI designated fax number using their fax cover sheet as their confirmation verification about the number of claims submitted.  Tesia-PCI contacts the offices if there is a discrepancy in the number of claims received to the number indicated on the fax cover sheet.

þ      Claims received are converted to Image files

þ      Image files are converted to raw data files using Tesia-PCI BPO Image-To-EDI systems

þ      Once data is indexed and converted, claims are routed to Quality personnel for QC

þ      Tesia-PCI personnel QA each file and segregate claims into approved/rejected claims

þ      Claims data is then converted to the pre-defined client format (ANSI X12 837; NSF; Propr)

þ      Claims are delivered to Payor via agreed upon method/format (FTP / web interface)

þ      Verification reports &  Claim Status / Reject report are prepared by Tesia-PCI systems

þ      Reports are faxed back to submitting providers informing of rejected claim details

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