Medical Billing Services

For healthcare providers that offer critical care services, optimizing the medical billing process is a primary focus area to ensure sustained, long-term operations. From streamlining the complex collections process to overcoming continual declines in reimbursements and satisfying HIPAA requirements, there are a number of tasks that constitute the medical billing process and lead to the successful close of a revenue generation cycle. Outsourcing to Invensis Technologies, a leading Medical Billing Outsourcing Services company, will enable your healthcare business to accelerate the pace of revenue generation, reduce operational expenses and increase the efficiency delivered by the system.

Invensis is an expert provider of outsourced HIPAA compliant Medical Billing Services. We provide end-to-end medical billing bpo services and act as a mediator between insurance companies and hospitals or healthcare providers. Healthcare organizations are faced with the possibility of losing large quantities of money every year due to under-pricing, coding errors, non-reimbursed claims and missed charges. When you outsource medical billing services to Invensis, we provide output of the highest quality and accuracy, and eliminate the occurrence of these losses.

End-to-End Medical Billing Outsourcing Services

Eligibility Verification/Pre-Insurance Verification: Before the patient's visit to the provider, we perform pre-insurance verification to check eligibility regarding the particular insurance, requirement for any pre-authorization or referral, whether any copayment has to be collected, if the patient has met the deductible, the amount of co-insurance the patient shares, and whether the patient's insurance covers the service sought from the provider. This step is important because many insurance providers do not provide retro-authorization.
Medical Coding: We access the superbills and detailed patient information from the physician's office through a secure network. The medical documents are verified and their validation is communicated to the client. The healthcare documents are then sent to the medical coding department to assign CPT and ICD codes. The coded documents are subjected to proof-reading and cross-checked by the medical coding manager. The coded documents are then forwarded to the charge entry team. We also validate the code entered by the clients. Invensis is getting ready for the ICD 10 change.
Charge Entry: The charges from the coded documents are entered into the particular patient account. If the patient is new and an account number does not exist as yet, then the patient account is created by entering all the demographic details from the patient registration form. Before transmitting the claims to the insurance payer through the clearing house, the entered charges are audited by the Quality Assurance (QA) team to ensure a 'clean claim' is submitted.
Claims Transmission: Once the charges are entered and audited, the claims are then filed with the payer electronically. We also have the capability to process paper claims. Usually at clearing houses, the claims go through some type of cursory filtering software to ensure that they are accurate and all information is contained within the document. Within 24 hours, a paper report is sent back with errors that have been caught. Once we have the report, the incorrect claims are rectified with the necessary information within 24 hours and the claims are resubmitted to the insurance company.
Payment Posting: When our team of experienced medical billing outsourcing professionals receives scanned EOBs (Explanation of Benefits) and checks, these payments are entered into the system. As part of this task, we also charge appropriate patient accounts and initiate the process for denied claims in case actual claim is far below the expected one. Reconciliation takes place on a daily basis.
Accounts Receivable Follow-Up / Insurance Follow-Up: Once the claims are submitted to the payer for processing, our expert medical billing BPO follow-up team resolutely pursues all unpaid insurance claims that have crossed the 30 days bucket in order to reduce the accounts receivable (AR) days of the claim. Sometimes, the claims are underpaid by the insurance payer, and in this case, we ensure that the underpaid claims are processed and paid correctly. The denied claims are appealed by our AR team.
Denial Management: The denied claims are addressed on priority basis - our billers and coders find the missing puzzle pieces fast, and re-file or appeal the denial. We have Denial Analysts on board who fix the issue and send the claim for reprocessing. If the claim needs more information from the provider, then these gaps are filled promptly; if the claim is denied and the patient is responsible, the claim is billed to patient.
Patient Follow-Up/Patient Statements: We follow up with patients for any pending balance due after the insurance claim is processed A patient statement is generated and filed on a weekly or monthly basis, as per your business requirement. Follow-up is done through phone calls. If no response is received from the patient, we move those balances to collections, generate a report for it and send it to you for further action.
Reports: Our reporting package contains monthly customized reports, including insurance aging reports and Key Performance Indicators (KPI) report, offering a detailed picture of your practice's financial health and the length of your claim payment cycle.
Credit Balances: As part of our medical billing outsourcing services, we can perform credit balance processing of the payer or patient, after verifying that it is a case of overpayment. This ensures correct and timely refunds to the appropriate entity.
Provider Enrollment and Credentialing: We offer a comprehensive range of medical billing and healthcare BPO services. We complete all applications and necessary paperwork on your behalf with the chosen payer networks and government entities. We follow all payer contracts through to contract load date and provide copies of fully executed contract and fee schedules to your practice or billing company. We also maintain and update CAQH profile.

Outsource Medical Billing Services to Invensis to Improve Revenue and Efficiency

With over 19 years of experience in the BPO domain, Invensis possesses robust capabilities that will benefit you when you decide on outsourcing medical billing services to us:

Stringent Data Protection:

Invensis has achieved HIPAA compliance and is ISO 27001 certified. We ensure stringent data security measures are in place for Protected Health Information, and all other confidential information related to your business.

Assured Accuracy:

As an ISO 9001 certified company, we follow the highest quality management standards and global best practices to ensure that the outputs generated for your business are accurate and within the specified deadline.

Swift Turnaround Time:

Invensis professionals are trained to deliver timely results. You will also derive significant time zone advantage by outsourcing to us. This will enable the revenue cycle to be optimized for your company.

Scalability:

Invensis has the capability to ramp up the resources assigned to your project as per your business requirement. With the appropriate outsourced manpower and technology allocated for your organization, any additional burden on your employees will be off-set and they can focus on achieving mission-critical objectives.

Differentiating Advantage:

With Invensis support for all your healthcare BPO needs, including medical billing, medical record indexing, medical data entry, medical customer service, receivables management, claims processing and more, your business will get a competitive edge in the dynamic business landscape.

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