Case Study on End-2-End medical billing

Services:

  • Insurance verification
  • Medical coding
  • Demographic entry
  • Claims entry
  • EDI rejections
  • Payment posting
  • Secondary billing
  • Denial management
  • AR follow-ups.

Billing system: Medics Premier

The Client: A fast growing radiology practice management group in NJ.

Challenge Analysis: BOSS was initially approached by the group to take care of charge and demographic entry. The company decided to offshore because of the following reasons:

  • Employee turnover
  • Claims not submitted on time
  • Incorrect posting and refunds
  • Improper denial handling and outstanding AR days
  • Steep decrease in cash flow and inverse increase on claims outstanding.
  • The Client wanted to hand over the billing side to us in 2 months if he gets satisfied with our ability on the AR Management (we did a good job and the owner of the clinic handed over the billing part as promised).
  • We had to use a new software namely Telnet & other Hospital system access for carrying out the operations. We got cross-trained over phone on the practice management software.

The Project:

  • To provide full billing service..
  • To handle average of 700 claims every month

The client had mentioned in advance that we will have to handle heavy workload often and complete it within 24 hrs.

The BOSS’s Seven Solution:
BOSS brain storm session on all areas of billing with client and came up with solutions which would enhance the clients billing process and improve cash flow in a cost saving program.

  1. BOSS quickly ramped up the team with short notice and provided a dedicated client relation and account mangers with defined no of staffs as per client’s claims volume outsourced.
  2. BOSS provided complete full time staffs for billing cycle department
  3. BOSS provided dedicated QA (quality analysis team), to quality check on all the data entry work
  4. Documents and manuals prepared as per clients specification on each Dr’s entity which will evolve a medical billing and AR process management.
  5. Aggressive follow-ups on outstanding claims and appropriate actions initiated. BOSS registered online solutions for claims and insurance verification with insurance.
  6. BOSS executed all billing done with 24hours turnaround time.
  7. Daily log report sent the client on claims entry and payment posting.

The Results:

By outsourcing their End-2-End medical billing to BOSS, the CLIENT was able to:

  • Witness that the average AR days were brought down from 47 to 23 days within 6 months
  • Witness that the collection percentage increased from 41.5% to 62% within 6 months
  • Have significant improvement in the cash flow as a result of increase in collection ratios
  • Concentrate on client relations, business development and other core activities with the availability of more time.
  • Client was able to save 47 percent on overheads
  • Client was able to increase the volume at any given time without any expense on overheads
  • Existing client staffs were promoted to be supervisors over the billing and increased in business and rapport with their heath care provider clients
  • All billing works are done with 24hours of client business time and Increase operating efficiency and reduce administrative costs
  • Client witnessed 30 percent increase in their invoice excluding their cost saving by outsourcing their back office billing work to us.

Please see the graphs below:

Progress since we started 2009 2008
Collections % (rolling 6 months) 62.60% 55.20%
Average A/R Days 24 34
A/R over 90 days as % of total 14 20

About Boss Healthcare:

BOSS is an Offshore Medical Billing Company based in Chennai, India providing medical billing services to physician practices, hospitals, practice management groups and third party medical billing companies of all sizes and specialties across US. Our services include, Insurance Verification, Patient Answering, Medical Coding, Demographic Entry, Claims Entry, Submission of Claim, Payment Posting, Denial Management, Accounts Receivables service and Revenue Cycle Management.

“We always spell sUccess with U”

Want outsource your Insurance Verification, Patient Answering, Medical Coding, Demographic Entry, Claims Entry, Submission of Claim, Payment Posting, Denial Management, Accounts Receivables service and Revenue Cycle Management.