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:
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Centralized
Appointment Scheduling |
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A toll-free
number, available 24*7 is based in the Indian office. All doctors’
appointment’s 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 doctor’s office. |
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B) |
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Appointment
Confirmation |
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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. |
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C) |
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Eligibility and
Benefits Verifications |
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We verify each
patient’s insurance plan and benefits information, once an
appointment is scheduled. This is done through the insurance
company websites or automated systems. We verify patient’s
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 doctor’s
office. |
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D) |
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Medical Billing &
Coding / Insurance Claims Filing |
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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.
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Claims
Transmission |
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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.
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F) |
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Clearing House
and Insurance Rejections Handling |
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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. |
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G) |
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Denials Handling |
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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. |
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H) |
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Insurance Ageing |
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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: |
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i) |
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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.
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ii) |
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A claim was
transmitted and the insurance company received it. In this
case, we put the note Received and in process. |
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iii) |
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The claim is paid
by the insurance company. In this case, we note the payment
date, the amount of payment and the check number. |
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iv) |
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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. |
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The ageing
analysts work in the night shift here. This is the time when
all Insurance company offices are functional in the US. |
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I) |
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Patient
Collections |
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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. |
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J) |
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E O B
Posting |
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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.
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K) |
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Accounting |
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We help you
handle payroll processing, maintain and process accounts payable
and provide monthly and quarterly analysis of income/expenses. |
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L) |
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Data Analysis and
Report Solutions |
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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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ÛÝ |
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