By shortening the "days in healthcare accounts receivable" cycle, Outsource2india is able to help improve your cash flow and reduce claims denials, thus turning healthcare accounts receivables into cash. Outsource2india can help with AR calling, following up pending claims, initiating collections, tracing the reasons for claims denials, tracking outstanding receivable balances by customer and by the date when payment is due, providing periodic reports and more.
O2I's AAPC-certified medical coders know the ins and outs of both diagnostic coding and procedural coding. They are experienced at handling CPT and HCPCS coding. We code for surgery, lab and other tests based on the guidelines of AMA and CMS. We also do ICD coding related to the CPT and HCPCS codes based on AMA and CMS guidelines. Read more about our medical coding services.
We will use Medicare as an example but this could apply to Medicaid or other third party insurance companies as well.
Medicare claims get denied mainly for the following reasons.
As you can see, some of the main reasons for claims denials are incorrect/incomplete data entry and incorrect medical coding.
Outstanding claims and delayed collections place added administrative strain on a hospital or physician's practice. On one hand, insurance companies often deny claims or refuse to pay them. On the other hand, federal regulations have become increasingly more stringent in the USA. Recently the federal Centers for Medicare & Medicaid Services announced that they would reduce the time physicians are given to file an appeal against a claim denial - from six months to 120 days. This increases the pressure on the staff at your healthcare practice to follow up on denied or appealed claims.
Outsource2india helps you avoid payment delays from Medicare as well as from other third-party insurance payers by following these steps:
1. We review all claims before submission
This cuts down significantly on the error rate. We spend time on reviews at the front end, rather than spend a longer time later to deal with each denial.
2. We maintain a billing and coding claims review log
We track the trends for each healthcare BPO provider, based on the remittance advice from Medicare as well as the EOBs (Explanations of Benefits) from all third-party payers. We monitor and evaluate these trends to find ways to fix the problems causing the denials and rejections for your practice.
3. We do a monthly billing review
All the staff involved in the accounts receivable function, i.e., those who perform tasks such as data entry, coding and documentation, billing and payment posting, analyzing denials and down codings get together once a month to review -
Outsource2india has the experience, the people, the technology and the in-depth domain knowledge to address your specific needs in healthcare accounts receivables management.
If you want to ensure that you get paid promptly and in full for each healthcare claim, and actually increase your revenue by up to 20%, outsource your healthcare accounts receivables department to Outsource2india.
Do you require high quality, customized medical claims processing services? Why not consider outsourcing to India? Read more specific information about O2I's Healthcare infrastructure. Discover more about outsourcing clinical services to O2I.
If you would like to find out more about outsourcing medical claims processing work to O2I, please fill in the inquiry form and our Client Engagement Team will contact you within 24 hours.