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Outsource Medical Billing Process

Our Medical Billing and Coding Process is Secure and Accurate

As a busy healthcare provider, you need a medical billing solution you can count on. Thatís where Outsource2india excels! We have a proven record of success in expert medical billing procedures. Our medical billing process flowchart shows how our focus on accuracy and quality ensures the best results for your practice.

Medical Claims Submission Process - 8 Steps

Claims Transmission
Claims Transmission
1
Retrieval & Checking of Medical Claims
Retrieval & Checking of Medical Claims
2
Medical
Coding
Medical Coding
3
Charge
Creation
Charge Creation
4
Medical
Claims Audit
Medical Claims Audit
5
Medical Claims Transmission
Medical Claims Transmission
6
Claims Submission to Agencies
Claims Submission
7
Follow-up and Settlement
Follow-up and Settlement
8
  1. Claims Transmission to O2I: The hospital forwards the claims to our medical billing team digitally or via courier. The medical claim is supported by patient details such as charge sheets, a copy of the insurance card, demographics, insurance verification data, super bills, and any other patient related information. All such documentation is then uploaded to our secure FTP server for access by our expert staff.
  2. Retrieval and Checking of Medical Claims by our Team: Once the documents are retrieved, they are checked for legibility and completeness. If necessary, the hospital billing office is notified so that any discrepancies can be solved.
  3. Medical Coding: An important step in the medical claims submission process is fixing the procedure and diagnoses codes for each patient based on standards like CPT (Current Procedural Terminology) and ICD-9 (International Classification of Diseases, Ninth Edition). The level of service determines the associated 5-digit procedure code; the diagnosis code is based on the medical diagnosis made by the doctor.
  4. Charge Creation: Incomplete or incorrect information is the number one cause of medical claim rejections. Our expert medical billing professionals will guard against this by careful attention to detail. We create appropriate medical claims based on billing rules pertaining to specific carriers and locations. All medical claims are created within agreed turnaround times - generally 24 hours. The medical claims are checked for complete information, correct procedures and correct diagnosis codes.
  5. Medical Claims Audit: A thorough medical claims audit is done at multiple levels within O2I.
  6. Medical Claims Transmission: Medical claims are filed for follow up before they are sent electronically to the claims transmission department with all relevant information
  7. Claims Submission to Insurance Agencies: The audited, listed and recorded medical claims are now printed out and dispatched to the appropriate insurance agencies. Any necessary attachments or supporting documents that may be required for ultimate settlement are included.
  8. Follow-up and Settlement: In this final stage our expert medical billing team follows up with the insurers and payment agencies until the final settlement is disbursed.

Our Medical Billing Procedure: See the O2I Advantage

Outsource2india has over 12 years of experience in providing expert medical billing services to healthcare service providers, medical billing companies and insurance companies in the US. and UK. Our services include patient demographics entry, charge entry and posting, accounts receivable and claims follow-up.

Quality Assurance at O2I

  • Medical claims audit
  • Strict quality control standards
  • Quality assurance reviews of all claims before submission
  • Billing and coding claims review log
  • Monthly billing review

Communication Best Practices

  • Email, fax and voice communication
  • Use of templates and protocols to streamline medical billing process. Both O2I and the customer review updated spreadsheets and medical billing review logs
  • All electronic documents preserved for 120 days unless otherwise specified (with all paper documents being destroyed)

Security Measures at O2I

  • Confidentiality of billing data
  • Restricted employee access to files and folders
  • Patient data privacy
  • Secure FTP servers
  • Systematic data back up of all patient visits
  • Detailed internal data and communication back up

Compliance Standards at O2I

  • HIPAA compliant
  • Trained in regulations related to Indemnity Insurers, Managed Care, Medicaid, Medicare, Preferred Provider Organizations, Third-Party Liability, Workers Compensation,
  • Proficient in medical claims standards such as CPT, HCPCS, ICD-9
  • Proficiencies in Medical Coding - Level I, II, III

Rest Easy by Outsourcing Your Medical Billing to India

Outsourcing medical billing is a common practice today, and Outsource2india has the skill set and experience to deliver cost effective, quality results. We are a well-established medical billing service with significant experience in the industry.

We are well aware of the U.S. medical billing practices.

With adequate training and knowledge-sharing mechanisms in place, we ensure that each of our staff members has access to vast knowledge repositories on the latest changes in the medical billing domain.

Read more about the advantages of outsourcing medical billing to India.

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