Healthcare Revenue Cycle Management

In the present state of affairs, the medical billing companies have been facing

anomalous issues due to constant technical and software up-gradation, initiation of

novel medical reforms and a multitude of insurance carrier policy changes. Medical

billing can be very demanding and challenging for many medical firms which lack

skilled manpower to perform the tasks efficiently. And thus to alleviate such concerns

Outsourcing comes into picture.

The various features which makes Outsourcing stand apart from the traditional

methods includes:

Cost: The total capital involved in Outsourcing includes solely the partnering

cost which is thin on the ground compared to the labour cost, claim

processing costs and hardware and software cost that are intricate in In-

House Medical Billing. An average company spends about 30-40% of their

collections on Medical Billing, and this could be saved through Outsourcing

where the capital spent on training and updating software could be avoided.

Accuracy: Outsourcing comprises of numerous medical coding companies

possessing skilled professionals capable to work under pressue with high

accuracy on ICD-10 coding set and thus leads to minute errors in coding and

claim approvals. Whereas In-House Medical Billing has massive impact on

time management and payment outcomes for heath providers and thus leads

to minimum level of accuracy due to the basic training provided to the staff

because of transformation in the coding set from ICD-9 to ICD-10.

Compliancy: Outsourcing provides with the Updated Certified Compliance

with knowledge of relevant regulations and expertise in compliance process to

assist services and guide offshore vendors with ultimate transparency which

is important to bring forward medical billing and coding functions smoothly.

Improved Cash Flow: With the essential technological advancement and

exceptional workforce to labour on the medical coding and billing, the cash

flow would increase exponentially in Outsourcing unlike the In-House Medical

billing where the Revenue Cycle affects drastically due to numerous medical

denials. By outsourcing medical billing, companies can save a lot of time and

money in terms of salaries, office infrastructure, purchasing, upgrading, and

maintaining billing software. With the reduction in overhead costs, timely

submission of claims and increased reimbursements will result in increased

revenues for the firm.

Turn-around Time: The Contract signed during the initial period leads to on

time discharge of the product thereby achieving the target in the stipulated

time. And since Indian Time Zone falls under Indian Standard Time (IST)

which is 9 hours and 30 minutes ahead of the US Time Zone (GMT-4), this

would avail an added advantage of outsourcing if provided to Indian vendors,

as they would deliver it 12 hours prior.

Accounts Receivable Management

Accounts Receivable is an important aspect of businesses’ fundamental analysis. It

is the capital or balance of money due to the Providers or Medical Billing Companies

for the services or treatment provided to the patients but not yet paid back from their

(patients) end. Whereas Accounts Payable is the money owed by patients for the

services availed. The Staff keeps a record of all the accounts and thereby generates

invoices to intimate patients regarding the amount due in-case of unpaid/denied

claims and makes sure that the payment reaches on time. Also, they strive to

minimize the Accounts Receivable Days (AR Days) and thereby debar the aged AR.

And thus maintains the stability of the company’s revenue cycle.

Claim Denials is one of the primary knots to be untied periodically and to have

a closer shave on it on a regular basis a highly qualified staff is necessitated.

A competent pool of staff pinpoints the root cause of claim denials and

dissects it to identify the problem area for the claim rejection and

subsequently works on it to correct them and refill the claims without any

further delay. Also necessary steps are taken to avoid the denials with similar

patterns arising by-and-by.

Timely follow-up is an utmost requisite for any firm that has direct linkage with

the customers. And thus a good Accounts Receivable (AR) Team with a

functional and logical plan will keep a constant trace on the logged claims and

makes sure that the dues are settled within the stipulated time of 30 days

thereby ensuring no underpayment or over-payment.

A good rapport with the customers paves the way for a smooth functioning of

the financial section and thus it is highly mandated to maintain a good

relationship with the patients so as to avoid any delay in the payments. And a

level-headed medical billing company keeps a constant follow-up with the

patients through emails and phone calls, which makes it easier to receive the

dues within the given duration.

Auditing provides efficiency and profitability to any firm or organization. Such

frequent audit helps in maintaining the transparency, provides assurance to

the end users and also helps in learning the areas of improvement. The report

thus generated includes AR Reports, Outstanding Payments Reports, etc.

These reports thereby help the Medical Billing Companies to achieve the

objective in discharging the functions.

Profitable Revenue

The primary goal of all Medical Billing Companies is to earn profit, not only for

themselves but also for the patients. But in the current scenario, these companies

face huge revenue loss due to multiple areas of governance which includes hours of

investment in medical coding services and digging ways to get back the mislaid

money on denied money claims.

Thereupon, outsourcing comes as a redeemer for those companies which look

forward to enhance business operations. Establishing tie-ups with e-Rad for medical

coding services helps in overcoming adverse factors such as compliance control and

self -pay. The added merits for Outsourcing include:

Inaccurate Coding. Giving primary importance to coding in the foremost stage,

helps in erasing most of the denials undoubtedly and ultimately paves way for

a better revenue generation.

E-Rad, a well established vendor follows a systematic process which includes

coding, validation, rectification and delivery. And this is solely possible with a

team of highly skilled and certified professional working in accord with the

policies of the Company.

Confidentiality. Patients entrust the medical companies with their personal

information and safeguarding it holds the utmost priority. Our company holds

HIPAA compliance and possess twin ISO certifications such as ISO

9001:2015 for operational processes; and ISO 27001:2013 for ISMS

(Information Security and Management systems). These certifications hold

exceptional value in terms of security during patient data transactions.

Universal Standards. With the constant up-gradation in the field of information

and technology, it has become imperative to be at par with the universal

standards. Therefore, e-Rad possesses an entourage of well-trained coding

technicians who exemplify exceptional medical coding services such as ICD-

9-CM, CPT-4, HCPCS coding, ICD-10-CM, and ICD-10-AM.

Customization. Outsourcing doesn’t take over the entire medical operational

process but instead undertakes an important section which enhances the

business operations. Also, an important feature in Outsourcing includes

fashioning of the business operations as per the requirement by the Medical

Companies which in-turn gives the company the ultimate powers to run as per

their norms and guidelines.

Medical Billing

In a pool of competitors all around, any organization for the matter of fact needs to

validate its stand in the market. And if it isn’t able to make it to the top 10 list, it’s high

time to check for the alternate proceedings that would help attain the top spot.

Medical Outsourcing is one important modification that needs to be undertaken for

an exponential Revenue growth. Not only does a physician or hospital provider need

to provide optimal patient care, but they must also translate that quality care into

complete documentation and subsequent accurate codes to survive and facilitate

accurate reimbursement. Outsourcing renders an added coign of vantage. It

includes:

Trust is the most important business and brand asset one can manage,

especially in relationships with customers, clients, employees, or customers.

The challenge with trust is that one cannot buy it or force customers to believe

one’s organization is trustworthy. The company must work to earn trust

through its services. E-Rad, an offshore medical billing company streamlines

its services and strives to accomplish and retain the trust by working efficiently

and delivers the aforementioned output with exceptional accuracy in the given

window. Thus, it leaves no room for any revenue loss but instead helps the

company grow substantially thereby retaining the Brand Value.

Referral system is an age old epitome for success, be it for an individual or

an organization. But, one would refer others only if they themselves are

satisfied and impressed with the performance and services provided. Thus,

gaining trust of existing clients take the supreme stand as it paves way for

other clients to approach and invest. Outsourcing would not only help to

expand the client figures but would also provide a huge flow of revenue and

double the growth of the company.

Happy Patients. For most patients, going to the hospital itself is time-

consuming, and in certain cases, a bad experience. Not only do they have to

come to terms with the various medicines and care they need to adhere to,

but also understand the costs involved. A knowledgeable and friendly staff

can ensure that your patients remain happy throughout their stay, while all the

financial problems are handled by an expert service provider. This means you

won't have to harry patients with financial matters and they can deal directly

with the professional medical billing staff of the service provider. This helps

everyone to work more effectively and efficiently.

Why Opt for Medical Coding Services from India?

Outsourcing medical coding services to India helps to save on time, effort and

resources. Moreover, the added benefit of Outsourcing to Indian Companies

is that the Indian coders are professional, skilled and well-versed in

International Coding practises. Also, the Indian companies constantly develop

and refine internal compliances of contract to meet the requirements of the

customers. e-Rad has a professional and well-trained team of proficient

medical coders with relevant experience in delivering high- quality medical

coding services within the stipulated TAT. The benefit doesn’t terminate here

but instead opens door to several added merits. It includes:

Whenever there emerges a confrontation of any healthcare update, our well

equipped team contemporizes by commencing a training session based on

the novel standards. This helps the medical billing companies to concentrate

on their code medical billing functions without having to ponder upon the

coding process. This in-turn would lead to decrease in denials, fasten AR

follow-ups, cuts down cost and ultimately boosts the chances of

reimbursements.

Outsourcing acts as an extension to your back office – its basically a part of

the practise. E-Rad remains responsive to the needs of the company and

pulls your burden to alleviate administrative load from your practise and

services so that the transition becomes smooth and easy.

Indian Time Zone falls under Indian Standard Time (IST) which is 9 hours and

30 minutes ahead of the US Time Zone (GMT -4), this would avail an added

advantage of outsourcing if provided to Indian vendors, as the medical billing

and coding services could be delivered 12 hours prior.

Outsourcing Credentiality and enrolment Services reduces the operational

costs to a considerable extent which eliminates errors and eventually leads to

delay in enrolment. e-Rad manages every client on one-on-one basis. This

ensures that all the enrolment and credentialing formalities are assiduously

taken care with faster processing and resolution of any enrolment or

credentialing issues right from filing the applications to approvals on a priority

basis. Also it provides the medical company with more time to concentrate on

patients and building your practises which eventually saves you from tons of

paperwork and hours of frustration.

Outsourcing the billing processes to a third party vendor is truly safe as they

have a HIPAA- compliant and offer 100% security to safeguard against any

hacking attempts and ensure that the data breaches are completely avoided.

Thereby, the personal details and private health information of all patients are

protected.

Outsourcing Disaster Recovery is a fundamental decision that’s need to be

made. Being In-line with the business operations at the time of conjuncture is

indeed challenging and during such times of emergency Outsourcing allows

the company to carry out the business operations and services smoothly.