GoTelecare Medical Billing & Coding Services

GOTELECARE SERVICESMEDICAL BILLING & CODING

2© GoTelecare 2015-16| All Rights Reserved Private & Confidential

‘Onshore /Offshore’ KPO & BPO Services Serving US healthcare industry since 2007 Robust & scalable infrastructure State-of-the-art technology and systems Highly skilled and trained staff with good

communication skills and in-depth knowledge of process

Structured training, feedback and coaching HIPAA-HITECH compliant Offices located in US & India

• New York City, US – Situated in Manhattan (facility inbuilt with all redundancies – power, infrastructure and others)

• Kolkata, India – Situated in the IT Hub(facility inbuilt with all redundancies – power, infrastructure and others)

Sun Knowledge, our contracted company, is ISO 27001:2005 and ISO 9001:2008 certified company.

CMMi-SVC implementation in progress under KPMG guidance

Member of NASSCOM, the Governing Industry body for IT/ITES in India

Awarded ‘Best Emerging BPO Company of the year 2010’ by The Economic Times, India

Recognized as one of the foremost 'Emerging companies in Eastern India' by NASSCOM in 2011

Awarded Asia-wide “Healthcare BPO Provider of the Year” at the Asia BPO Excellence Awards ceremony hosted by Asia BPO Summit on 14th February 2013 in Mumbai, India

Awarded the prestigious “Outsourcing Service Provider of the Year” award in the Asian Outsourcing Excellence Awards ceremony hosted by CMO Asia on 1st August 2013 in Singapore

Awarded “Highest New Job Creator (IT/ITES)” by STPI (Software Technology Parks of India) on 3rd December 2015

GoTelecare – Overview

Key Facts Awards, Affiliations & Certifications


MEDICAL BILLING & CODING SERVICES


REVENUE CYCLE MANAGEMENT – OVERVIEW

Revenue Cycle Management Components

Billing

Coding

Account Receivables

Eligibility Verification & Authorization

Scheduling

Payment Posting


REVENUE CYCLE MANAGEMENT – SERVICE PORTFOLIO

Billing Patient entry demographics & insurance information Fee schedule / charge entry Scrubbing of all entries for correctness and completeness through appropriate billing edits; correction of identified errors Submission of claims to payers, e.g. EDI or paper Creation and mailing of patient statements Posting of payments received from patient and payer Reconciliation of charges, payments received and adjustments made

Denial Management and A/R Follow-up Denial Management, e.g. understanding denials and making corrections Resubmission of claims AR calls as follow-up on outstanding issues Closure of a claim once the balance is zero

Medical Coding Inpatient/Outpatient Hospital Coding Physician Coding


MEDICAL BILLING & CODING – HIGHLIGHTS

Above 95% Collection Rate Claims Submission TAT 24 – 48 hours max. Error-free Patient Entry Over 99.9% Coding Accuracy Real Time Audits Proactive Follow-up on Rejections Denial Management Methodical and Proactive AR Follow-up 100% HIPAA Compliance Custom Reporting


MEDICAL BILLING & CODING – HIGHLIGHTS

We provide Medical Billing Services in the following areas:

Urgent Care Inpatient Hospitalization DME (Durable Medical Equipment)

Pathology Critical Care Radiology

Pulmonary EKG Ambulatory Surgery Center

Cardiology ENT Orthopedic Surgery

Anesthesia Family Practice Internal Medicine

Rehab Center Pharmacy Physician Group, and more…


MEDICAL BILLING – CYCLE

Encounter (SOAP) notes review

Superbill generation and code review

Claims edit checking and correction

EDI claims submission through clearing house

Rejection managementERA/EOB posting and reconciliation

Automatic secondary payer billing

Denial Management

AR Follow-up


BILLING SYSTEM

We use Kareo for coding and billing services that covers the complete billing cycle:

SOAP notes review

Superbill generation and coding

Claims edit checking and correction

Claims submission through EDI clearing house at a scheduled time

Rejection management

ERA/EOB posting and reconciliation

Automatic secondary payer billing

Denial Management

Patient statement generation and mailing


CLIENT BENEFITSMEDICAL BILLING - PAYMENT/DENIAL POSTING

Select Patient Account

Select EncounterSelect Encounter If not found

Refer Client SpecifiesDenial

Denial Code

Hold Transfer BalanceTransfer BalanceWrite-off

Post Payment

Payment

Payment Entry Process-Flowchart

Payment posting is a crucial step in billing process, looking at the sensitivity of this process, accurate and efficient payment posting process is indispensable for Physicians office.

Our billers are known to be highly efficient and analytical in payment posting process.

The flow chart below illustrates the Payment Entry process followed.


Go Telecare – 5 DISTINCT ADVANTAGES

1Over 8 Years of Experience in Working as Vendors for

Major Health Insurance

Companies Across US

Deep Knowledge of the Payer Side

of the US Healthcare Spectrum

2Consistent

Performance in Delivering 97% Collection Rate

to Clients

Already

Recovered over millions in

Account Receivables

and continuing…

3The Only

Medical Billing Company with Its Own State-

of-the-Art Telemedicine

Platform

4The Best

References in Every

Segment of US

Healthcare Knowledge &

Business Process

Outsourcing

5The Lowest

Prices* in the Market!

* Only $10 / hour for a dedicated and

knowledgeable billing expert

working on the client account

Very Little Risk• Proven track record in providing healthcare BPO/KPO services• Experienced in providing services to both payers and providers• Experienced working with various software platforms• Quick and efficient resource for special projects requiring technical and process expertise

Significant Upside Potential• Great understanding of the Healthcare Industry. Operation scale-up with a short notice• Extremely competitive rates, greater productivity, improved quality, increased member and provider

satisfaction

Proven Process Performance• Low denial rate reduced collection time increased revenue collection• Billing & Coding Accuracy > 99.9%; TAT: 24 – 48 hours • Adherence to CMS billing requirements

Clear Communication and Quick Response Time at All Times

ISO 27001:2005 & HIPAA Compliance for End-user Data Privacy and Protection

WHY US?

12Private & Confidential© GoTelecare 2015-16| All Rights Reserved


MORE INFORMATION

GoTelecareRonnie Hastings41 Madison Avenue, 25th Floor, New York, NY 10010 Phone: +1 6466617853E-mail: [email protected]

For Additional Information, Please Contact…

mailto:[email protected]