SUCCESS
STORIES

Medical Coding

Background:

ABC is a leading provider of state-of the-art medical billing, consulting and practice management solutions in Pennsylvania, PA. Since the last 15 years, ABC has been offering comprehensive billing services to its clients. ABCs range of services include: medical coding services ( both CPT & ICD-9 CM), data compilation and demographic verification, third party billing, payment posting, accounts receivables management, physician credentialing, managed care tracking, management tracking, patient enquiry services, and physician training for appropriate documentation standards. ABC signed up new contracts with radiology doctor groups for medical coding services using CPT, HCPCS level II and ICD-9 CM codes. The accounts were online diagnostic radiology coding with backlogs as much as 4-6 months. Processing of these claims and coding was being handled by the company's internal Billing office. ABC's team found it extremely challenging to keep pace with the increasing volume of the backlog, taking into consideration that approximately more than 1000 patient encounters were being added each day.

Key Challenges:

• Increased workload to keep up with both the backlog and existing DOS.
• Short Turn Around Time demand for getting the charts ready for charge entry.
• Limited Quality Control cover.
• Deteriorating accuracy levels.
• Workforce ramp-up in Billing Office required- leading to higher costs.

The Medusind Approach & Solution:

• Medusind's team identifies and recommends outsourcing of medical coding services to its offshore facility.
• Medusind's CPC & CPC-H certified team with American Academy of Professional Coders (AAPC) takes charge of the processes.
• Focus on operational efficiencies to minimize turn around time for the client.
• 24/7 operations leading to a catching up on the backlog.
• Flexibility with staffing allowing more coders put on this project.
• Implementation of inhouse developed quality tools & processes.
• Quality initiatives focused on continuous improvement and reducing error rates drastically.
• Daily reporting to client with value added statistical analysis.

Benefits to Client:

• Working on the backlog as well as existing DOS helped the client in catching up with the expected delivery numbers. Medusind team generated approx. 8000 reports within 22 days.
• Excess capacity created at client end, enabling the client for faster business growth, without adding to cost.
• Shortened Turn Around Times for generating 'clean' claims ready for submission.
• Increased revenues on ongoing basis.
• Medusind flexible staffing and working hours ensuring marked increase in productivity numbers.
• Raised end client satisfaction level by helping ABC eliminate backlog and become current.

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