gotelecare medical billing & coding services
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GOTELECARE SERVICESMEDICAL BILLING & CODING
2© GoTelecare 2015-16| All Rights Reserved Private & Confidential
‘Onshore /Offshore’ KPO & BPO Services Serving US healthcare industry since 2007 Robust & scalable infrastructure State-of-the-art technology and systems Highly skilled and trained staff with good
communication skills and in-depth knowledge of process
Structured training, feedback and coaching HIPAA-HITECH compliant Offices located in US & India
• New York City, US – Situated in Manhattan (facility inbuilt with all redundancies – power, infrastructure and others)
• Kolkata, India – Situated in the IT Hub(facility inbuilt with all redundancies – power, infrastructure and others)
Sun Knowledge, our contracted company, is ISO 27001:2005 and ISO 9001:2008 certified company.
CMMi-SVC implementation in progress under KPMG guidance
Member of NASSCOM, the Governing Industry body for IT/ITES in India
Awarded ‘Best Emerging BPO Company of the year 2010’ by The Economic Times, India
Recognized as one of the foremost 'Emerging companies in Eastern India' by NASSCOM in 2011
Awarded Asia-wide “Healthcare BPO Provider of the Year” at the Asia BPO Excellence Awards ceremony hosted by Asia BPO Summit on 14th February 2013 in Mumbai, India
Awarded the prestigious “Outsourcing Service Provider of the Year” award in the Asian Outsourcing Excellence Awards ceremony hosted by CMO Asia on 1st August 2013 in Singapore
Awarded “Highest New Job Creator (IT/ITES)” by STPI (Software Technology Parks of India) on 3rd December 2015
GoTelecare – Overview
Key Facts Awards, Affiliations & Certifications
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MEDICAL BILLING & CODING SERVICES
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REVENUE CYCLE MANAGEMENT – OVERVIEW
Revenue Cycle Management Components
Billing
Coding
Account Receivables
Eligibility Verification & Authorization
Scheduling
Payment Posting
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REVENUE CYCLE MANAGEMENT – SERVICE PORTFOLIO
Billing Patient entry demographics & insurance information Fee schedule / charge entry Scrubbing of all entries for correctness and completeness through appropriate billing edits; correction of identified errors Submission of claims to payers, e.g. EDI or paper Creation and mailing of patient statements Posting of payments received from patient and payer Reconciliation of charges, payments received and adjustments made
Denial Management and A/R Follow-up Denial Management, e.g. understanding denials and making corrections Resubmission of claims AR calls as follow-up on outstanding issues Closure of a claim once the balance is zero
Medical Coding Inpatient/Outpatient Hospital Coding Physician Coding
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MEDICAL BILLING & CODING – HIGHLIGHTS
Above 95% Collection Rate Claims Submission TAT 24 – 48 hours max. Error-free Patient Entry Over 99.9% Coding Accuracy Real Time Audits Proactive Follow-up on Rejections Denial Management Methodical and Proactive AR Follow-up 100% HIPAA Compliance Custom Reporting
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MEDICAL BILLING & CODING – HIGHLIGHTS
We provide Medical Billing Services in the following areas:
Urgent Care Inpatient Hospitalization DME (Durable Medical Equipment)
Pathology Critical Care Radiology
Pulmonary EKG Ambulatory Surgery Center
Cardiology ENT Orthopedic Surgery
Anesthesia Family Practice Internal Medicine
Rehab Center Pharmacy Physician Group, and more…
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MEDICAL BILLING – CYCLE
Encounter (SOAP) notes review
Superbill generation and code review
Claims edit checking and correction
EDI claims submission through clearing house
Rejection managementERA/EOB posting and reconciliation
Automatic secondary payer billing
Denial Management
AR Follow-up
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BILLING SYSTEM
We use Kareo for coding and billing services that covers the complete billing cycle:
SOAP notes review
Superbill generation and coding
Claims edit checking and correction
Claims submission through EDI clearing house at a scheduled time
Rejection management
ERA/EOB posting and reconciliation
Automatic secondary payer billing
Denial Management
Patient statement generation and mailing
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CLIENT BENEFITSMEDICAL BILLING - PAYMENT/DENIAL POSTING
Select Patient Account
Select EncounterSelect Encounter If not found
Refer Client SpecifiesDenial
Denial Code
Hold Transfer BalanceTransfer BalanceWrite-off
Post Payment
Payment
Payment Entry Process-Flowchart
Payment posting is a crucial step in billing process, looking at the sensitivity of this process, accurate and efficient payment posting process is indispensable for Physicians office.
Our billers are known to be highly efficient and analytical in payment posting process.
The flow chart below illustrates the Payment Entry process followed.
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Go Telecare – 5 DISTINCT ADVANTAGES
1Over 8 Years of Experience in Working as Vendors for
Major Health Insurance
Companies Across US
Deep Knowledge of the Payer Side
of the US Healthcare Spectrum
2Consistent
Performance in Delivering 97% Collection Rate
to Clients
Already
Recovered over millions in
Account Receivables
and continuing…
3The Only
Medical Billing Company with Its Own State-
of-the-Art Telemedicine
Platform
4The Best
References in Every
Segment of US
Healthcare Knowledge &
Business Process
Outsourcing
5The Lowest
Prices* in the Market!
* Only $10 / hour for a dedicated and
knowledgeable billing expert
working on the client account
Very Little Risk• Proven track record in providing healthcare BPO/KPO services• Experienced in providing services to both payers and providers• Experienced working with various software platforms• Quick and efficient resource for special projects requiring technical and process expertise
Significant Upside Potential• Great understanding of the Healthcare Industry. Operation scale-up with a short notice• Extremely competitive rates, greater productivity, improved quality, increased member and provider
satisfaction
Proven Process Performance• Low denial rate reduced collection time increased revenue collection• Billing & Coding Accuracy > 99.9%; TAT: 24 – 48 hours • Adherence to CMS billing requirements
Clear Communication and Quick Response Time at All Times
ISO 27001:2005 & HIPAA Compliance for End-user Data Privacy and Protection
WHY US?
12Private & Confidential© GoTelecare 2015-16| All Rights Reserved
13© GoTelecare 2014-15| All Rights Reserved Private & Confidential
MORE INFORMATION
GoTelecareRonnie Hastings41 Madison Avenue, 25th Floor, New York, NY 10010 Phone: +1 6466617853E-mail: [email protected]
For Additional Information, Please Contact…