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Insurers & Partners
Insured Members
Healthcare Providers
Mailroom / Document Management
Mailroom
Customers send documents in bulk and reduce mailroom costs by routing mail directly to Crescent Care’s post office box. Crescent Care’s mailroom service frees customers from the headaches of opening and sorting, enabling them to benefit from naturally occurring economies of scale and making this process automated.
Mailroom
Customers send documents in bulk and reduce mailroom costs by routing mail directly to Crescent Care’s post office box. Crescent Care’s mailroom service frees customers from the headaches of opening and sorting, enabling them to benefit from naturally occurring economies of scale and making this process automated.
Management Document
After preparing and classifying the document, they are sent to the scanner. The scanner can print a document control number (usually the date followed by a sequential number) on each page that passes through the scanner. This embossing feature eliminates the need to manually date stamp each document.
Management Document
After preparing and classifying the document, they are sent to the scanner. The scanner can print a document control number (usually the date followed by a sequential number) on each page that passes through the scanner. This embossing feature eliminates the need to manually date stamp each document.
Policy Administration
The Customer/insurer/policyholder details are entered in the Crescent Care application system. After carefully checking the uploaded data, the insured person’s health insurance cards are printed.
Policy administration includes appropriate additions, deletions, and changes to policy benefits and coverage throughout the year. 24/7 call center service is available to provide support and handle insured inquiries.
Utilization Management
The network claims pre -approved services for elective treatments and surgeries . Review claims and coordinate with physicians, hospitals and other providers within & outside the network to determine the appropriate level of benefit consumption under policy/privilege terms as per client protocol and established guidelines.
Utilization Management
The network claims pre -approved services for elective treatments and surgeries . Review claims and coordinate with physicians, hospitals and other providers within & outside the network to determine the appropriate level of benefit consumption under policy/privilege terms as per client protocol and established guidelines.
Case Management
We employ a gatekeeper approach of advising patients and assisting qualified physicians as case managers to direct the services they need, ensuring the quality of care provided to our members and its cost effectiveness. Expert case managers monitor members’ well -being from admission to discharge and manage unnecessary tests, medications and malpractice.
Case Management
We employ a gatekeeper approach of advising patients and assisting qualified physicians as case managers to direct the services they need, ensuring the quality of care provided to our members and its cost effectiveness. Expert case managers monitor members’ well -being from admission to discharge and manage unnecessary tests, medications and malpractice.
Claims Management
Our service strives for a complete implementation of an automated end-to-end process flow until successful claim settlement. The aim of the current medical scrutiny done at CC to identify some of the points listed below: Inappropriate billing pattern, Detection of customary overcharge, Duplicate billing detection, Visiting Doctor charges, Fee schedule, Verification of pharmacy and investigation bills for reasonableness, To filter unnecessary admissions, To monitor length of stays, Necessity of hospitalization
Claims Management
Our service strives for a complete implementation of an automated end-to-end process flow until successful claim settlement. The aim of the current medical scrutiny done at CC to identify some of the points listed below: Inappropriate billing pattern, Detection of customary overcharge, Duplicate billing detection, Visiting Doctor charges, Fee schedule, Verification of pharmacy and investigation bills for reasonableness, To filter unnecessary admissions, To monitor length of stays, Necessity of hospitalization
Insurers and Partners
Crescent Care Services Healthcare policies are tailored to the needs of the customer/insurer. CC can also assist clients/insurers in designing healthcare plans with their needs in mind. By working with existing policies, CC allows clients to monitor medical policies without interfering with daily administrative processes.
Insurers and Partners
Crescent Care Services Healthcare policies are tailored to the needs of the customer/insurer. CC can also assist clients/insurers in designing healthcare plans with their needs in mind. By working with existing policies, CC allows clients to monitor medical policies without interfering with daily administrative processes.
MIS Reporting
Crescent Care can create customizable MIS reports for their customers. With the latest software available, CC can produce a variety of regular MIS reports according to standard protocols and customer requirements. A sophisticated MIS system with CC enables all customer service representatives to provide customers with the information they need to reach their goals.
Reports
Call history report, Benefit redemption report, Pre-approval detail report, Billing Detail Report, Disease trends report, Group overview report, Other reports as per the mutual agreement
Reports
Call history report, Benefit redemption report, Pre-approval detail report, Billing Detail Report, Disease trends report, Group overview report, Other reports as per the mutual agreement
Value Added Services
Disease management, Preventive care programs, Advanced case management, Provider network management, Product development, Other value additions as per understanding.
Value Added Services
Disease management, Preventive care programs, Advanced case management, Provider network management, Product development, Other value additions as per understanding.
Technology Infrastructure
Crescent Care technology infrastructure includes the latest technology servers, workstations and high-speed scanners, networked through state-of-the-art technologies.
CC uses encrypted SSL and VPN technology for communication between Insurance Companies, Providers and Groups with CC systems that ensure secure transmission of data. We use load balancer to ensure 24/7 internet connectivity through multiple providers.
Disaster Recovery
Crescent Care has developed a disaster recovery process as an integral part of its business continuity plan. Below are some of the key components of disaster recovery:
- Data backup and recovery plan
- Simultaneous onsite and offsite backup
- Proactive server maintenance
- Log changes to the server system
- Hardware-level fault tolerance
- Availability of identical replacement hardware
- Staff training on disaster recovery procedures
- Document recovery procedures
- Regular exercises to test the disaster recovery process
