REVENUE CYCLE MANAGEMENT

The revenue cycle is defined as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. In the most simplistic and basic terms, this is the entire life of a patient account from creation to payment. We take care the end to end process starting from Medical Transcription, Medical Coding, Medical Billing, Payment Posting, AR Calling and Denial management.

MEDICAL TRANSCRIPTION

*         HIPPA compliant

*         Fully trained in-house managed Transcription team

*         Both Offshore and Onsite service

*         Geographically distributed On-shore and Off-site service centers

*         Backed by excellent infrastructure with redundancy and failsafe disaster management

*         Client customized Flexible TAT options

*         Committed accuracy levels

*         More than 19 years industry experience

*         Excellent and satisfied client credentials

*         Easy dictation through toll free lines and other modes of dictations like Records and FTP uploads

*         Auto pooling of voice files across geographically spread out transcriptionists and organization

*         Dynamic fly-by-online control of voice and document management at all stages of transcription, editing and upload

*         An online workflow management controls work status at any given point of production

*         Workflow wizard not only controls the production and quality but transmission, printing and facing and mailing of documents within minutes of completion

*         Online editing of the documents and generation of quality and editing logs for continuous training and quality improvement

*         Batch signing and e digital signing of documents

*         Highly customized file naming conventions tailored to suit specific client needs

 

REVENUE CYCLE MANAGEMENT

*         Our services include:

*         Billing Services

*         Coding Services

*         Provider Credentialing

*         Patient Scheduling

*         Benefits and Eligibility verification

*         Demographics entry

*         Charge entry

*         Claim generation and transmission

*         Payment Posting and Adjustments

 

PROVIDER SERVICES

*         We help physicians focus on their core function by:

*         Operational streamlining to maximize revenues

*         Serving Multi-Specialty physician groups and clinics

*         Improve operational efficiency and productivity, compliance adherence

 

BILLING SERVICES

*         Billing Constraint mitigation and higher revenue realization by ensuring claims are paid accurately and in a timely fashion through:

*         Better managed Provider credentialing, patient demographics, charge entry, claim generation, AR follow up and payment posting.

*         Beyond Billing, Bringing Higher Revenues

*         Meticulous review of review of coverage and policy details, explanation of benefits (EOB) and patient medical records

*         Efficient biller team minimizes the rejections and insurance denials and reduce the AR days.

*         Assured charge entry and payment posting functions, maintaining a TAT of less than 24 hrs.

*         Working across various states, billing platforms & conventions, for seamlessly transition of billing responsibilities.

*         Continuous domain knowledge and skill updating through continuous training on CMS Medicare updates, AMA updates, NCCI Edits and LCD Validations.

 

CODING SERVICES

*         Our strength is Compliant, Correct, and Consistent Coding

*         Service offering across wide specialties including Radiology, OB-Gyn, Neurology, Cardiology, Anesthesia, Orthopedics and Gastroenterology, Pain Management.

*         Our professional team comprises qualified doctors and AHIMA/AAPC Certified Medical Coders.

*         Services guarantee 98-100% accuracy with complete CMS compliance and guaranteed turnaround of 24-48 hours.

*         Risk mitigation with transparent access and consistent accuracy of less than 0.2% error rate.

*         Continual focus to hone the skills to meet the ICD-10 coding requirements.

 

A/R RESOLUTION & DENIAL MANAGEMENT SERVICES

*         Our A/R analysis and denial management targets meeting the predefined objective so that our clients receive the reimbursements due to them.

*         Our target is to ensuring our clients success in maintaining a less than 60 day payment cycle.

*         Our A/R task is highly inclusive comprising thorough review of the Insurance Policy Details/Explanation of Benefits/Patient's Medical Records, enlisting and ascertaining parties liable for the pending payment and regular follow-up with the liable party (Insurance/Patient) for the payment recovery.

*         Our value additions include A/R analysis, A/R follow-up, Denial management and conduct Practice financial performance analysis to improve our client RCM.

 

PAYMENT INTEGRITY AND AUDIT SERVICES

*         Our USP is to help our client recover lost dollars & enhance their revenues through a retrospective review of your zero balance claims, with zero upfront investment!

*         Through our 'Payment Integrity Audit services' we help identify the payment variances through retrospective review of claims & recover them.

*         We help mitigating the payment variances through manual review & analysis of complex Payer contracts where the complexities are, increasing the likelihood of payment inconsistencies.

*         Our Payment Integrity Audit services help drill down the payment variances and help realize otherwise lost revenues.

 

PAYMENTS & POSTING

When our team of experienced medical billing outsourcing professionals receives scanned EOBs (Explanation of Benefits) and checks, these payments are entered into the system. As part of this task, we also charge appropriate patient accounts and initiate the process for denied claims in case actual claim is far below the expected one. Reconciliation takes place on a daily basis.