142   M
Insurance documents processed annually
12 M  +
Adjudication annually
22  
Top insurace companies rely on SourceHOV
700 K 
Claims processed daily

What we offer

 

SourceHOV Healthcare delivers a complete portfolio of technology-enabled solutions that support the entire spectrum of back-office processes used by healthcare insurers.

From enrollment and claims processing to full adjudication and reimbursement integrity, SourceHOV offers automated, secure, and streamlined processes designed to deliver exceptional financial accuracy and less re-processing, while also reducing costs significantly.

How We Can Help

 

Member Enrollment Services & Healthcare Exchanges

Quote to card

Secure, web-based platform for effectively managing healthcare enrollments and documentation

Member installation

Learn more about this Service


Health Line

Nurse guidance and advice

Learn more about this Service


Appointment Scheduling App

Scheduling appointments

Insurance verification

Dashboard analytics: view by provider/facility/date 

Learn more about this Service


Pharmacy Orders App

Real-time visibility into pharmacy insurance coverage

Learn more about this Service


Provider Data Management

Credentialing

Contract management

Installation

Learn more about this Service


Claim Submitted via PCH Global™

Accomodate large volumes of claims electronically or via mailroom

Single channel for paper and EDI

Mailroom: sorting, scanning, data capture

Data verified and pre-claim edits → clean claim

Real-time notification and visibility of any deficiencies and status of claim

Client-specific validation

Learn more about this Service


Adjudication

Clean claims

Business rules integration | pre-edits | authorisation

Contract fee schedule

Remittance/payment

Explanation of benefits/liabilities mailed

Exception management

ePresentment of denials

Learn more about this Service


Claims Audit Services

Nurse review

Customised compliance audits

Consistent rule updates

Claim checked against contract database for optimal billing

Learn more about this Service


Payer Payments

Paper or electronic transactions and lockbox (BancHub)

Manage reports

Adjustment

Daily deposit log

ERA conversion

Learn more about this Service


Revenue Integrity

Overpayment identification and recovery

Dashboards and solutions-driven reports using big data analytics

Predictive analytics

Learn more about this Service


Call Centre Support

Claims-related inbound and outbound call centre support, with 24/7 coverage

Learn more about this Service


Storage, Archival & Retrieval

On-premises and/or cloud-hosted

Security and compliance

Amendment tracking

Summarisation and dashboards

Learn more about this Service


Unified Communications Services

Live or virtual agent

Patient outreach and disease management

FAQ

EOB correspondence: print and mail

Billing automation (payment by IVR)

Scheduling and support

Mobile apps

Learn more about this Service


Accounts receivable management, Debt Collection

Pre-delinquency, third party debt, and legal collections

Credit reporting

Learn more about this Service

Member Enrollment Services & Healthcare Exchanges

Quote to card

Secure, web-based platform for effectively managing healthcare enrollments and documentation

Member installation

Learn more about this Service


Health Line

Nurse guidance and advice

Learn more about this Service


Appointment Scheduling App

Scheduling appointments

Insurance verification

Dashboard analytics: view by provider/facility/date 

Learn more about this Service


Pharmacy Orders App

Real-time visibility into pharmacy insurance coverage

Learn more about this Service


Provider Data Management

Credentialing

Contract management

Installation

Learn more about this Service


Claim Submitted via PCH Global™

Accomodate large volumes of claims electronically or via mailroom

Single channel for paper and EDI

Mailroom: sorting, scanning, data capture

Data verified and pre-claim edits → clean claim

Real-time notification and visibility of any deficiencies and status of claim

Client-specific validation

Learn more about this Service


Adjudication

Clean claims

Business rules integration | pre-edits | authorisation

Contract fee schedule

Remittance/payment

Explanation of benefits/liabilities mailed

Exception management

ePresentment of denials

Learn more about this Service


Claims Audit Services

Nurse review

Customised compliance audits

Consistent rule updates

Claim checked against contract database for optimal billing

Learn more about this Service


Payer Payments

Paper or electronic transactions and lockbox (BancHub)

Manage reports

Adjustment

Daily deposit log

ERA conversion

Learn more about this Service


Revenue Integrity

Overpayment identification and recovery

Dashboards and solutions-driven reports using big data analytics

Predictive analytics

Learn more about this Service


Call Centre Support

Claims-related inbound and outbound call centre support, with 24/7 coverage

Learn more about this Service


Storage, Archival & Retrieval

On-premises and/or cloud-hosted

Security and compliance

Amendment tracking

Summarisation and dashboards

Learn more about this Service


Unified Communications Services

Live or virtual agent

Patient outreach and disease management

FAQ

EOB correspondence: print and mail

Billing automation (payment by IVR)

Scheduling and support

Mobile apps

Learn more about this Service


Accounts receivable management, Debt Collection

Pre-delinquency, third party debt, and legal collections

Credit reporting

Learn more about this Service

Request a Call Back