Synergy helps control fraud, waste and abuse and allows costs to be contained
within reasonable and predictable boundaries.
Medical Insurance has been available market for decades and is now the major
source of non-life premium income in the insurance industry.
Products offered by risk holders, sponsors, and insurance companies tend to
focus on traditional benefits and scopes of coverage. They also offer clients
Inpatient (including Day Patient) coverage, Outpatient/Ambulatory coverage
providing cover for Laboratory tests, MRI and X-ray tests, Out Patient procedures,
etc... Companies also offer cover for Chronic Diseases, Specific Dental Treatments
as well as Optical Aids.
Synergy handles the claims management of its clients for all medical benefits
offered, on either a direct billing or reimbursement basis through the utilization
of an advanced I.T. solution for the logging of received claims and invoices from
providers.
Using an AI driven provider price recognition and tracking, along with automated
coverage rules, our team of experienced auditors review all incoming claims to
determine both medical appropriateness of supplies used and medical procedures
applied and also in conjunction with our system, ensure that the prices and
necessity, applied are in keeping with the contracted prices at the provider.