Medical Billing

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TREATING YOUR PATIENTS EFFECTIVELY IS ONLY HALF THE CHALLENGE OF A SUCCESSFUL MEDICAL PRACTICE, RUNNING IT AS AN EFFICIENT BUSINESS IS THE OTHER HALF.

Our Competitive Edge :

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Ensuring integrity, confidentiality and availability of patient health information is a technological challenge for individual healthcare specialists, small professionals, medium size and large organizations. TechCentra BPO Inc. understands that the need for privacy and information security is an essential requirement of HIPAA. We take pride in serving our customers and health care providers share responsibility for establishing and maintaining secure access to patient information by implementing various compliance methodologies. Also the clients can be rest assured that we keep abreast of all the latest rules & regulation changes in the insurance industry and coding & billing updates.

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 Secondly, Techcentra enables its clients to focus on their key competencies by outsourcing non - core health information management activities, leading to improved efficiencies and revenue enhancement for its clients.

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 We are committed to  HIPAA  compliance and maintaining total confidentiality on patient accounts, fee schedule and all proprietary information.

We help physicians obtain payment from insurance carriers and patients by providing the following comprehensive services:

  A)  
Centralized Appointment Scheduling
 

A toll-free number, available 24*7 is based in the Indian office. All doctorsí appointmentís can be scheduled from the centralized office. This is a major step towards cutting down manpower requirements as only 2-3 employees are required for this job rather than a full-time person in each doctorís office.

       
  B)  
Appointment Confirmation
 

A day prior to the encounter day, every patient scheduled for an appointment is given a call from the centralized office and the appointment is either confirmed or cancelled. Also, he/she is reminded of any documents/reports that he has to get along with him. If the patient is not available on the phone, then a message is left on the answering machine.

       
  C)  
Eligibility and Benefits Verifications
 

We verify each patientís insurance plan and benefits information, once an appointment is scheduled. This is done through the insurance company websites or automated systems. We verify patientís demographic information, insurance Id#, co-pay, name of Primary-care-physician, policy effective date and policy termination date if available. If there is any missing or incorrect information then the patient is informed about it during appointment confirmation or when the patient visits the doctorís office.

       
  D)  
Medical Billing & Coding / Insurance Claims Filing
 

To create an insurance claim, the ICD/CPT codes, referring provider, UPIN number, prior authorization number, etc are entered and each claim is reviewed to ensure that it is HIPAA (Health Insurance Portability Accountability Act) compliant. Our billers are trained extensively to bill HCFA 1500 claims accurately. They are provided in-depth training to bill for specialists, nursing homes and hospitals.

       
  E)  
Claims Transmission
 

As claims get reviewed, they are transmitted electronically or by paper. Once the claim is accepted by the clearinghouse it is further transmitted to the respective insurance company.

       
  F)  
Clearing House and Insurance Rejections Handling
 

If the claim is rejected by the clearinghouse or by the insurance company, we fix the claim within 24 hours and resend it. We track the clearinghouse and insurance rejections on an ongoing basis.

       
  G)  
Denials Handling
 

Denials are the crux of the whole billing process. We at Techcentra possess understanding of each stage of the billing process to handle denied claims effectively.

       
  H)  
Insurance Ageing
 
Ageing is the process through which we determine claims status a few days after a claim has been transmitted. Broadly, there are four types of claims status:
  i)   A claim was transmitted electronically or by paper but the insurance company has not received it. In this case we transmit the claim once again.
  ii)   A claim was transmitted and the insurance company received it. In this case, we put the note Received and in process.
  iii)   The claim is paid by the insurance company. In this case, we note the payment date, the amount of payment and the check number.
  iv)   A claim has been denied. In this case, we note the denial reason and tag the claim. The denials team analyzes and fixes denied claims.
       
     

The ageing analysts work in the night shift here. This is the time when all Insurance company offices are functional in the US.

       
  I)  
Patient Collections
 

We ensure that co-payment, co-insurance amounts and deductibles are collected by carrying out benefits verification, training front-desk staff and sending monthly bills to patients for outstanding balance.

       
  J)  
E O B  Posting
 

Every insurance company sends the providers a bi-monthly statement known as E O B (Explanation of Benefits) along with the payment check. The amount paid by the insurance company is posted in the system. If any balance is due, we figure out whether it is to be billed to secondary insurance or to the patient or to any other entity.

       
  K)  
Accounting
 

We help you handle payroll processing, maintain and process accounts payable and provide monthly and quarterly analysis of income/expenses.

       
  L)  
Data Analysis and Report Solutions
 

Our system provides extensive Financial Reports to analyze all stages of the billing cycle and to measure the overall productivity of a physician's practice.

     

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