Healthcare

The Affordable Care Act (ACA) has brought many changes to the healthcare sector, which requires modern equipment and facilities. Here comes the need for healthcare BPO processing service agents, who can help the organization save the time and money, which is explained below.

Medical Data Entry Outsourcing Services for a Range of Requirements

Data Entry Services

Data has become a critical part of every organization and we will assist you with the various data entry services such as online and offline data entry, product data entry, manual data entry, excel data entry, and much more.

Our medical data entry experts possess competencies for performing medical data entry for any type of clinical data, such as:

  • Hospital Records
  • Tests or Lab Records
  • Clinical and Healthcare Records
  • Demographic Entries
  • Charge Entry
  • Payment Posting
  • Medical Insurance Claim Forms, including UB-04, HCFA, CMS-1500, UB92,
  • Text and Numeric Data Entry
  • All Patient Information, Chart Information, Appointments, Account Information, Insurance Details, Notes from the Doctor, Billing etc.

End-to-End Medical Billing Outsourcing Services

Eligibility Verification

Before the patient's visit to the provider, we perform pre-insurance verification to check eligibility regarding the particular insurance, requirement for any pre-authorization or referral, whether any copayment has to be collected, if the patient has met the deductible, the amount of co-insurance the patient shares, and whether the patient's insurance covers the service sought from the provider. This step is important because many insurance providers do not provide retro-authorization.

Charge Entry

The charges from the coded documents are entered into the particular patient account. If the patient is new and an account number does not exist as yet, then the patient account is created by entering all the demographic details from the patient registration form. Before transmitting the claims to the insurance payer through the clearing house, the entered charges are audited by the Quality Assurance (QA) team to ensure a 'clean claim' is submitted.

Claims Transmission

Once the charges are entered and audited, the claims are then filed with the payer electronically. Once we have the report, the incorrect claims are rectified with the necessary information within 24 hours and the claims are resubmitted to the insurance company.

Payment 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.

Patient Follow-Up

We follow up with patients for any pending balance due after the insurance claim is processed A patient statement is generated and filed on a weekly or monthly basis, as per your business requirement. Follow-up is done through phone calls. If no response is received from the patient, we move those balances to collections, generate a report for it and send it to you for further action.

Denial Management

The denied claims are addressed on priority basis We have Denial Analysts on board who fix the issue and send the claim for reprocessing. If the claim needs more information from the provider, then these gaps are filled promptly; if the claim is denied and the patient is responsible, the claim is billed to patient.

Accounts Receivable

Once the claims are submitted to the payer for processing, our expert medical billing BPO follow-up team resolutely pursues all unpaid insurance claims that have crossed the 30 days bucket in order to reduce the accounts receivable (AR) days of the claim.

Our AR executives can quickly spot errors in rejected claims to ensure a rapid re-filing and appealing process.

  • Our healthcare outsourcing services can shorten your revenue cycle and increase your cash-flow.
  • Our trained AR members can deliver accurate results in the required timeframe.
  • Our AR executives can quickly spot errors in rejected claims to ensure a rapid re-filing and appealing process.