HealthCare Administrative Services Provided by Sun Knowledge

April 23rd, 2012

Apart from the services mentioned in our service tab, Sun Knowledge also specializes in a number of administrative services. With our extra ordinary infrastructure and dedicated staff base, we are capable of performing any administrative service in healthcare domain. Some of them are listed are below:

Administrative  Services
  • Provider Choice Letters
  • Provider Notifications (Newsletters and Regulatory)
  • Provider Satisfaction Surveys
  • Telephonic Health Plan Inquiries
  • Telephonic Provider Issues and Resolutions
Contracting Services
  • Contract updating and generation
  • Health Plans
  • Hospitals
  • Legal guidance
  • Legislative Updates
  • Providers
Accounting Services
  • 1099 Productions and Disbursement
  • Accounts Payable
  • Bank Statements
  • Capitation Reporting
  • Check Cutting
  • Check Register
  • Check Signing
  • Check Stock
  • Deposits and Transfers
  • Financial Accounting
  • Monthly Financial Statements
  • Profitability Analysis by Plan by Product Monthly
  • Reconciliation of Accounts
  • Risk Sharing Analysis and Management
Credentialing Services
  • Ancillary Provider Credentialing
  • Filing and Maintenance
  • Meeting material preparation
  • Provider Credentialing
  • Provider Databank Costs and Site Review Costs
  • Provider Reminder letters
Utilization Management Services
  • Auth Fax incoming
  • Auth Fax outgoing
  • Coalition Reports
  • Daily Census
  • Denial Processing Letters and Compliance
  • Health Plan audits
  • Inpatient Case Management
  • Meeting material Preparation
  • Monthly Health Plan reports
  • Out of Area Log
  • Outpatient Case Management
  • Quarterly Health Plan reports
  • Referral Processing
  • UM Annual Program
  • UM Statistical Reporting
Quality Management Services
  • Disease Management
  • Grievance and Appeals
  • Health Plan audits
  • Health Plan Reporting
  • P4P and HEDIS Measures
  • QM Annual Program and Coordination
Customer Care Services
  • Health Plan reporting
  • Health Plans Calls
  • Incoming Auth Inquiry Calls
  • Incoming Claims Inquiry Calls
  • Member Calls
  • Member Surveys
  • Provider Calls
Eligibility Services
  • Benefit Option and Copays Loading
  • Capitation to Eligibility Reconciliation
  • Electronic Eligibility Loading
  • Eligibility Reconciliation
  • Eligibility Reporting to PCP
  • Eligibility Template Maintenance
EDI/IT Services
  • CPT, HCPC, REV Coding Maintenance
  • Customized Management Reports
  • DOFR Maintenance and Verification
  • EDI Access
  • Encounter Data reporting
  • Fee Set Maintenance
  • Health Plan Options Maintenance
  • ICD-9 Maintenance
  • Inloading of Claims (Scanned and Electronic)
  • Off site back-up of data
  • PCs and Local IT Support
  • Phone Lines (Outbound and Inbound Phone Lines)
  • Provider data Maintenance
  • Scanning of Claims
  • System Support and System Redundancy
  • Vendor data Maintenance
Claims Services
  • Adjudication of Claims
  • Auditing of Claims
  • Health Plan Audits
  • Health Plan reporting
  • Mailroom (Batching/Sorting of inbound Claims)
  • Pre-check run Review and Modifications
  • Revenue Recovery Retro Terminations
  • Revenue Recovery VE
  • Third Party Payor Management
  • Virtual Examiner claims scrubber
Regulatory Services
  • Audit Preparation
  • Audit Scheduling
  • Fraud and Abuse monitoring
  • HIPAA monitoring
  • Implementation of new regulations
  • Regulatory updates to policy and procedure manuals

Outsource any of your administrative service needs to take advantage of our cost effective structure.