Claims Processing

Claims Processing


Outsource Medical Claim Processing Service in the USA – To Improve Patient Experience Management

Fusion CX aims to create meaningful connections between healthcare brands and their customers through efficient engagements and customized resolutions, delivering satisfactory experiences along the way. Using our comprehensive medical claim processing infrastructure, you will be able to ensure that your customers can access industry-leading customer service across multiple communication channels in over 40 global and regional languages.

As a result, we are able to connect with your customers on a personal and human level, delivering customized support in their native languages or a different language of their preference. Your customers can decide how they wish to communicate with brand representatives, and we will ensure consistent healthcare insurance claim processing solutions across the board.

Customized Healthcare Claim Processing Outsourcing Solutions for Your Organization

At Fusion CX, our primary focus is always on delivering the best experiences to your customers, regardless of why they choose to contact you. Through continued performance monitoring and VOC analysis, we determine precise customer requirements to deliver accurate solutions, maximizing service efficiencies for superior CX deliveries.

With medical claim process outsourcing to Fusion CX, you will be able to fine-tune your operational outcomes and reduces expenses simultaneously. This will ensure sustainable growth for your business, transforming your healthcare brand into an industry leader.


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    Insurance Eligibility, Coverage & Verification

    We will help you determine the medical treatments that your patients would be eligible for coverage with their insurance carriers to help you ensure efficient billing and payments. We will also help you verify insurance claims for authenticity and prevent fraudulent submissions and settlements.

    Claims Submissions, Processing & Settlements

    Outsourcing claim process to Fusion CX will also help you reduce manual errors and mitigate time-consuming practices with your claims submissions. This will help you ensure the swift processing of claims and help your healthcare business get paid at the earliest opportunity.

    Medical Necessity Review

    Our comprehensive medical claims processing solutions will help you determine the medical necessity of treatments suggested by physicians so that they can be billed with accuracy. With valid and insured treatments, you can maximize coverages and claim submissions for settlements.

    Benefits Adjudication & Support

    We will not only inform your customers about the treatments that will be covered and the ones that won’t be, but we will also provide your customers with detailed information about alternative treatments for uninsured treatments.


    Tech Support



    Ensured Business


    Reduced Costs

    Experience significant savings on operational costs without sacrificing quality. Eliminate the need for in-house teams and resources dedicated to claims processing.

    Expert Assistance

    Leverage the skills of seasoned professionals to ensure high-quality service. Minimize errors and expedite your claims process like never before.

    Easy Scaling

    No matter the volume of claims, scale your operations up or down seamlessly. Stay agile and responsive to market demands.

    Legal Safety

    Never worry about the ever-changing landscape of laws and regulations. Rest easy knowing your claims are being processed in full compliance with legal requirements.

    Core Focus

    Let your team concentrate on core business functions. While experts handle the claims, you can redirect your focus towards growth and customer service.

    Modern Tech

    Gain access to state-of-the-art technology and software for claims processing. Achieve unmatched efficiency and accuracy, leading to faster settlements.



    Why do you need Medical claim processing outsourcing services for your healthcare business?

    Managing healthcare and medical insurance claims submissions can be very tedious and tricky. Even a small mistake can amount to losses worth thousands of dollars. In addition, some mistakes can prove more costly if they violate industry regulations set forth by HIPAA and other regulatory compliances. These mistakes could lead to financial sanctions and create a negative reputation for your healthcare brand in the industry. Hence, professional Healthcare insurance claim processing services enable you to ensure compliant submission that will eventually maximize outcomes.

    Why should you opt for outsourcing the Medical claim process in the USA?

    It has often been seen that hospitals, private clinics, and other medical facilities that choose to submit and process insurance claims in-house are unable to achieve a high success rate. Moreover, dedicating core staff to such non-core competencies can limit the impact of the professional experts employed by the business. In addition, the team also takes out valuable resources from the industry, which can eventually prove to be very costly for the healthcare brand. Hence, it is better to outsource Medical claim processing to a professional company with the resources and expertise for such tasks.

    Why should you opt for Fusion CX for outsourcing medical claim process requirements?

    Fusion CX has been in operation in the medical industry for over three decades. Our extensive experience in the industry, combined with our comprehensive infrastructure, can significantly boost your billing, insurance claims, and payment structure. In addition, our healthcare insurance claim processing will help you maintain healthy relationships with your customers, clients, vendors, and other business partners, developing a positive brand reputation in the industry. We will also help you maximize settlements and payments with our competent outsourcing medical claim process customized to your business's requirements.

    How can outsourcing hospital claim processing services improve revenue cycle management?

    Outsourcing claim processing services can enhance revenue cycle management by streamlining the claims process, minimizing claim denials and rejections, optimizing coding and documentation, accelerating reimbursement cycles, and improving cash flow for hospitals.

    Are the claim processing services compliant with healthcare regulations?

    Yes, Fusion CX’s claim processing outsourcing services ensure strict adherence to healthcare regulations such as HIPAA (Health Insurance Portability and Accountability Act) to safeguard patient information and maintain confidentiality. Compliance and data security are top priorities in claim processing services.

    How do you ensure accuracy in hospital claim processing?

    To ensure accuracy, experienced claim processing service providers employ trained professionals and utilize advanced technologies to minimize errors. They conduct rigorous quality checks, perform claim validations, verify coding accuracy, and ensure proper documentation before claim submission.