Billed Right Medical Billing Process Flow Collaborative Outsourcing - - PowerPoint PPT Presentation

Billed Right Medical Billing Process Flow

Collaborative Outsourcing For A Changing World!

ACCESSSING SOFTWARE AT US PATIENT DEMOGRAPHICS ENTRY CHARGE ENTRY REPORTS TO CLIENT QUALITY AUDIT MIS / GENERATION OF REPORTS ACTION ON DENIALS / REJECTIONS

PROCESS - MEDICAL BILLING

TRANSMISSION OF CLAIMS THRU CLEARINGHOUSES

Paid Claims for cash application Unpaid Claims For corrective action

CASH APPLICATION AR ANALYSIS / CALLING CASH TALLYING

QUALITY AUDIT

Quality Audit for Patient Demographics and Charges before sending batch wise update to client After Quality Audit, files to be given to Supervisor / Manager for sending Batch Update to client. If any incorrect details found, Charges Team to be informed of the same and correction done Date of Service, Procedure Code, Diagnosis Code, Modifier, Units, Value, Place of Service, Type of Service, Referral, Prior Authorization, On bill comments, Location, etc to be checked in Charges File Patient #, Name, Address, SSN, DOB, Home Ph, Work Ph, Guarantor, Subscriber details, Employer, etc to be checked in Patient Demographic File

INSURANCE FOLLOW UP

DENIAL REASONS TREATMENT ELIGIBILITY INSURANCE FOLLOW UP CARRIER FEE SCHEDULE CLAIM STATUS COVERAGE INFORMATION PAYMENT DETAILS CONTRACT INFORMATION PROVIDER INFORMATION

PATIENT FOLLOW UP

T R E A T M E N T I N F O R M A T I O N P A Y M E N T I N F O R M A T I O N C O V E R A G E I N F O R M A T I O N P E R S O N A L I N F O R M A T I O N PATIENT

Month-end Financial Reports Doctor Financial Service Analysis Reports Audit Recap Patient Financial Aged AR

MONTH END REPORTS

• Client operations

team

• Billed Right service

delivery head

• Client functional

managers

• Billed Right transition

team

• Client functional

managers

• Billed Right analysis

team

• Client functional

managers

• Billed Right Functional

specialists Responsibility Ongoing engagement 2-3 weeks 1 weeks 1 weeks Timeline Onshore Onshore Onshore Onshore Location

• Operations accepts

service responsibility

• Quality plan put

into effect

• SLA acceptance
• Adapt process plan
• Emulate client process
• Confirm performance

requirements

• Customer acceptance
• Gather documentation
• Identify solution and

costing

• Confirm and validate

with client

• Prepare process

implementation plan

• Understand client

business needs

• Identify outsource
• pportunities
• Assess requirements
• Review environment
• Confirm viability

Key Activities Ongoing Operations Transition Management Analysis Pre-Analysis

Billed Right – GO Forward Road Map

Billed Right has the cutting edge expertise and technology in making Medical Coding a simple process through its Pocket PC solutions which is in its infancy stage. Billed Right has in its Agenda solutions like In-house Clearinghouse, Direct Transmission of claims to various Commercial Carriers, Direct Deposit of Checks from various commercial and other carriers etc. Submit most of the claims / patient statements electronically thereby reducing the reimbursement Turn Around Time. Create a Sync (EFT) between the Practice Management software / Bank Account of the Client / Insurance Company which will greatly reduce the Turn Around Time of reimbursement and reduce paper work to a greater extent.

DIFFERENTIATOR KEYS

T H A N K Y O U

Looking forward for a long term association with you.

Billed Right

URL : www.billedright.com