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SUCCESS
STORIES
Medical Billing
Background:
The client is a Practice Management company specializing in Radiology with group practice clients across the East Coast. Each group averages 10-12 physicians. Initially, Medusind was assigned Demographic Registration and Charge Entry. Exceptional quality in delivery of these work functions by Medusind prompted the client to outsource Coding and AR follow-up to Medusind as well.
Key Challenges:
- Backlog of Outstanding Charges to be entered.
- Some groups had poor quality of images, leading to incorrect entry.
- Improper dictation due to which coding could not be done to initiate accurate reimbursement.
- Poor demographics upload quality from the front end (Hospitals).
The Medusind Approach & Solution:
- Identified the key areas to fix front-end issues.
- Got image resolution improved for better accuracy of Demo and Charge Entry.
- Suggested changes in report dictation for better reimbursement from carriers.
- Regular updating of Insurance Carrier rules and policies.
- Brought Charges within acceptable polling period.
- Quality Assurance Team in place to audit all Processed Files.
- Better management of medical reports for easier retrieval.
- IT and Operations teams work in synch to create a process efficiency tool, which helped improve productivity and accuracy.
- Daily reports on productivity and workflow status sent to the Client.
Benefits to Client:
- Increased productivity - On an average 7000 CPTs were processed daily with a minimal error rate (0.5% to 0.75%).
- Percentage of clean claims billed to carriers improved drastically.
- End of Month being performed on time with sufficient charges entered.
- Reduced turnaround time and accurate work with Augmentation of Data.
- Client was able to allocate their staff to new business functions.
- Regular Reporting with value-added Statistical Analysis helped the client to understand financial trends and plan work better.
- The Client being happy with the results of this work decided to outsource Coding and AR follow-up to Medusind.
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"Medusind has been most effective and has delivered services in a highly efficient, accurate manner. We are most grateful for their intervention and intend to continue to utilize their services."
