The process specification will be subject to changes as per your requirement. Here below listed are the standardized specification as per the process and respective turn around time for each process. We have the pool of specialist on each process and periodic training will be provided to the team, the motto is to keep each and every one in the team to be unique in moving towards the target.
Coding: Based on the medical records / Office notes, we will interpret the report and code the files with in 24 hours from the received date by a certified coder.
Charge entry: The demography and charge entry will be completed with in 24 hours to 48 hours of TURN AROUND TIME (depends on the volume). The specification on charges will be followed based on the specialty specification or the specification provided by the customer. The ultimate aim of the team would be transmitting 100% clean claim which will reduce rejections and denials.
Claim Transmission: We will have a special attention towards the transmission of claims, which have the real impact on payment. Our motive is to get the payment at the earliest; we understand the delay in transmission will delay the payment.
Rejection: The front end and insurance rejection have a turnaround time of 12 hours; we believe working on rejection at the earliest will result in payment at the earliest. We will work smartly to reduce the rejection percent and to increase clear-claim percent.
Payment posting: The EOB payment will be posted in to application with-in 48 hours of turnaround time and the ERA payment will be posted with in 24 hours of turnaround time.
Current denial & Correspondence: The denials through EOB’s and ERA’s will be worked with in 48 hours of turnaround time and with assurance; all denials are acted promptly to result in payment.
Insurance AR: We believe, the team success is measured based on the AR percent in 90+ bucket, so we will plan the AR based on the age bucket and the $ value. The AR plan will be communicated to you for approval and ensuring that we will not deviate from the plan.
Patient AR: In this process we will ensure that the bills to the patient are sent promptly and timely manner based on the rules specified. The ultimate aim will be sending valid bills to patient without any error.
We will be more communicative as per the daily task; Daily reports will be sent end of every day on each process, to keep you posted on completion of day to day task expecting the prompt reply from you on all query emails to easy our work.