Losing money because of . . .
- High costs of Medical Coding and Medical
Billing?
- Denied claims due to wrong Medical Coding
and Medical Billing?
- Late Payments due to lack of skilled
employees?
Partner with INFINIT
OUTSOURCING and . . .
- Cut Your Medical Coding and Medical
Billing Costs In Half
- Recruit Highly Skilled People in 15 days
- Ensure High Quality and Security through
ISO Standards
- Experience Outsourcing with a Personal
Touch through an Outsourcing Partner with 20 Years Experience
- Outsource Without Losing Control through
our Dedicated Operating Team (DOT)
The
Business
The
Benefits
Why the
Philippines?
Services
Offered
THE
BUSINESS OF MEDICAL BILLING and MEDICAL CODING
It all starts when a patient visits the provider’s
office. The patient’s diagnosis and the services
provided are translated by a certified medical coder into numeric or
alphanumeric codes which are internationally recognized, International
Classification of Diseases, 9th Revision Clinical Modification
(ICD-9-CM), Current Procedural Terminology,4th Edition (CPT-4) and
Healthcare Common Procedure Coding System Level II (HCPCS)
codes. The medical biller then encodes everything to a
software. Following insurance and state specific guidelines,
the biller then submits the claim to the patient’s insurance
company either by paper or electronically.
As simple as it sounds, the same cannot be said about the actual cycle
of a claim.
The medical biller then needs to monitor the payment of these
claims. Following up for non-payment and questioning
underpaid claims. Another challenge that the medical biller
will experience is denial. The list of possible reasons for
denial or pending of claims continuously grows as laws, regulations and
guidelines are approved or changed. Human error plays a large
role as well. Depending on the State, the
top billing errors may vary, but a
few of the common errors include duplicate claims, medical necessity,
beneficiary eligibility, non-covered services and bundled
services. Whatever the reason for the denial, bottom line is,
the revenue of the healthcare providers is extremely affected.
In this regard, more and more healthcare providers outsource their
medical billing process to not deal with the headaches and pains
medical billing and medical coding may bring. This also
enables them to focus more on their core business which is providing
medical services.
BENEFITS OF
OUTSOURCING MEDICAL CODING AND MEDICAL BILLING
Outsourcing medical coding and medical billing tasks is a crucial
decision as this would greatly impact the way medical billing companies
and physician offices operate.
For the past couple of years, difficulties were encountered by
companies during their attempt to outsource their medical coding and
medical billing services. These challenges, from security
issues to quality problems, have left some companies skeptical.
But despite all of these, the fact that more and more companies now
outsource their medical billing tasks cannot be ignored.
Companies are now tapping the numerous benefits of outsourcing through
their partnership with the right outsourcing providers.
This strategic move empowered companies!
Outsourcing medical coding and medical billing tasks provided companies
access to highly-skilled resources and world-class
technology. To add, significant cost reduction of 30-50% made
companies embrace this move even more.
The headaches of medical coding and medical billing such as the ever
changing insurance guidelines, state laws, annual updates on ICD and
CPT codes, denied, pended and unpaid claims, are taken out of the
companies’ hands and minds. Submitting claims in a
timely and accurate manner as well as making sure that optimum
reimbursements are received are now the responsibilities of the
outsourcing partner.
The above benefits helped physicians focus more on their core business
which is providing care to their patients. Outsourcing also
enabled medical billing companies possess the capability of investing
on other areas such as business development and security
improvement. And because of the improved capabilities of
physician offices and medical billing companies, their quality of
service is greatly enhanced as well.
OFFSHORING
MEDICAL CODING AND MEDICAL BILLING TO THE PHILIPPINES
High staff attrition rate is one of the major challenges many companies
are facing. This cripples the operations of a company and
therefore correspondingly affecting revenue. The dilemma does
not stop here. Qualified employees are becoming a rarity as
companies try their best to maintain these people or even try to poach
them from their current employers.
After finding a qualified employee, there will always be a transition
period during training. As a result, though not as crippling
as not having one, production is still affected during this
period. And from then on, employers can only hope that the
newly-hired employee would be able to absorb everything as fast as
possible as well as stay longer.
Now, these issues can be addressed by
“outsourcing”. The burden of closing the
gap from the time a medical biller is lost to the time an employee
completes training and being able to perform the assigned tasks is now
the responsibility of the outsourcing provider.
But take note, the location of the outsourcing providers plays a key
role in the success of outsourcing these services.
Why the Philippines then?
. . . . because of scalability. The Philippines produces
380,000 graduates a year. As of July 2007, the employment
rate is at 92.2% where 33% worked for less than 40 hours a week
only. This 33% and the 7.8% unemployed Filipinos form a
substantial pool for new jobs and positions.
. . . . because of quality. Based on
UNESCO’s Analyses of Literacy Data,
the Philippines achieved 94% literacy for the year 2006. In
addition to this, the Philippines has a strong western affinity and is
regarded as the third largest English-speaking country in the world.
. . . . because of turnaround time. Because of the time
difference, work assigned at the end of US business hours is processed
immediately and claims are sent to insurance companies either
immediately for electronic claims or at the start of the following day
for paper claims. Faster turnaround means faster
reimbursement.
. . . . because of cost. The competitive cost of living in
the Philippines enabled outsourcing providers to price lower than their
competitors. This typically would result to 30%-50% cost
savings enabling companies to invest on other areas such as business
development, infrastructure and security.
SERVICES OFFERED
At Infinit-O, our highly trained and professional employees use the
latest world-class technology, business controls, ISO 9001:2000 quality
standards, ISO/IEC 27001:2005 security standards and our proprietary
framework to deliver meaningful results to our clients.
Infinit-O offers medical billing and medical coding outsourcing
services to Healthcare Providers and Medical Billing Companies.
Dedicated
Operating Team (DOT)
DOT is a hybrid outsourcing model that is specifically designed for
small and medium- sized companies.
You have complete control of the day to day operations whilst
Infinit-O’s team of experienced outsourcing experts implement
not just the set up phase but also manage all the support functions
such as HR, IT and Administration.
This enables you to quickly gain the advantages of running your own
in-house offshore operations and managing your own virtual employees
without the overheads and risks of doing it yourself.
Medical
Coding Outsourcing Services
Scanned doctor’s notes/operative reports/clinical
information/patient charts are either stored in your server which we
will view through a secure Virtual Private Network connection or sent
to us through File Transfer Protocol.
- ICD-9-CM Coding (International
Classification of Diseases 9th Revision Clinical Modification)
- CPT-4 Coding (Current Procedural
Terminology)
- HCPCS Level II Coding (Healthcare Common
Procedure Coding System)
- Health Insurance Prospective Payment
System Coding (HIPPS)
Medical
Billing Outsourcing Services
Eligibility
Verification
All necessary information such as the patient’s active
enrollment, coverage of procedures, need for referrals or prior
authorization are verified prior to the patient’s scheduled
visit or before a walk-in patient is seen.
Data
Entry of Patient Demographics and Insurance Information, Charges and
Payments
Scanned patient forms, superbills/charge slips and Explanation of
Benefits (EOBs) are uploaded to your server and viewed via a secure VPN
connection. These are then entered to the client’s
software.
Medical
Claims Submission
Medical claims are submitted electronically or manually to primary,
secondary and tertiary insurance companies.
Creation
and Mailing of Patient Statements
Statements are sent to patients with outstanding balances.
Accounts
Receivable Management
Outstanding accounts are monitored on a daily basis.
Medical claims with errors are corrected and resubmitted.
Insurance and patient follow-up of unpaid claims.
Resolution of denied and underpaid claims.
Report
Generation
Customized reports are provided daily, weekly or monthly, as defined by
the client.
Infinit-O also offers medical claims processing outsourcing services to
health insurance companies.
Medical
Claims Processing Outsourcing Service
New
Accounts Application Processing
Scanned application forms with corresponding attachments are viewed via
a secure VPN connection. These are then processed based on
client-specified requirements.
Member
Update and Maintenance
Member information are maintained in the client’s software
and are updated as necessary.
Medical
Claims Adjudication
Medical claims are adjudicated based on the members’
eligibility, plan benefits and exclusions, deductibles,
co-payments and coordination of benefits, diagnosis and
procedures and an array of special and client-specified
instructions.
Healthcare
Mortgage
Insurance
Legal Outsourcing
Finance
and
Accounting
Sales
Support
