Medical Billing Process at Outsource2india
As a busy healthcare provider, you need a medical billing solution you can count on. That's 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
The medical billing process flowchart at O2I follows a series of clearly defined steps with a complete focus on accuracy, quality and process audits. The following are the steps involved in the medical billing process at O2I -
Retrieval & Checking of Medical Claims
Medical Claims Transmission
Claims Submission to Agencies
Follow-up and Settlement
- 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.
- 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.
- 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-10 (International Classification of Diseases). The level of service determines the associated 5-digit procedure code; the diagnosis code is based on the medical diagnosis made by the doctor.
- 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.
- Medical Claims Audit - A thorough medical claims audit is done at multiple levels within O2I.
- Medical Claims Transmission - Medical claims are filed for follow up before they are sent electronically to the claims transmission department with all relevant information.
- 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.
- 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.
Medical records of patients at a hospital contain demographic details about the patient, summary of his medical history, summary of diagnoses and regular medical updates on each physician visit. The patient settles the payment by submission of his medical insurance details at the hospital front desk. It is implied that the hospital or healthcare facility receives the final payment only when the insuring agency settles the claim.
Advantages of Outsourcing Medical Billing Process to O2I
There are some of the most common concerns while outsourcing medical billing services to India, these are - chances of healthcare fraud, inaccuracies in submission of medical claims, non-conformance to existing Federal, State and Payer regulations, stringent compliance requirements and unfamiliarity with US medical billing laws.
Read an article to know more about healthcare fraud and abuse - a grave problem that needs attention.
However, Outsourcing Medical Billing Process to India can be a boon if you get in touch with reliable service providers like Outsource2india who follow all the rules and regulations, and can offer high-quality affordable prices. We have wide experience in offering healthcare outsourcing services including patient demographics entry, charge entry and posting, accounts receivable and claims follow-up, among others. Read more about the advantages of outsourcing medical billing to India.
Outsource2india has over 19 years of experience in providing expert medical billing services to healthcare BPO providers, medical billing companies and insurance companies in the US and UK.
1. 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
2. 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)
3. Security Measures at O2I
- Confidentiality of billing data
- Restricted employee access to files and folders
- Patient data privacy
- Secure FTP servers
- Systematic data backup of all patient visits
- Detailed internal data and communication backup
4. 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-10
- Proficiencies in Medical Coding - Level I, II, III
Outsource Medical Billing Services to O2I
Outsourcing medical billing is a common practice today and O2I has the skill, expertise, and knowledge to deliver cost effective, quality results. If you would like to find out more about O2I's medical billing services, please fill in the inquiry form and our Client Engagement Team will contact you within 24 hours.
We will be privileged to assist you through the outsourcing process by catering to all your medical billing requirements. Contact us today.