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Your Healthcare BPO Service Partner for Life

MedBillingExperts, a division of the Flatworld Solutions group, is a healthcare business process outsourcing (BPO) service provider offering an extensive portfolio of healthcare services to physicians, billing companies, healthcare organizations, and Insurance companies across the world. With over 10 years of expertise, we are committed to making medical back office services more optimized, efficient and cost and time effective. Today, we leverage state of the art technology, experienced workforce, and well-defined processes to serve more than 200 health care providers from India and 7 other global delivery centers.

Our Healthcare Back Office Services

Our holistic medical billing process includes patient registration, insurance eligibility verification, medical coding, charge entry, auditing, claims transmission, clearing house rejections, payment posting, denial management, AR recovery, patient statement, and collections. Our services are compliant to regulations that are robust and customized to your requirements for faster and better reimbursement. We leverage the most advanced medical billing technologies such as Nextgen, MediTouch eClinical works to promote an improved cash flow.
Our highly trained AAPC certified coders help to improve cash flow management and deliver up to 98% accuracy with their processes, while ensuring HIPAA and AHIMA compliance. We leverage a streamlined process that focuses on areas that are associated with high-risk MS-DRGs, RAC initiatives, high cost procedures, among others. Our entire medical coding services cover functions such as retrieving patient information, pre-coding, assigning medical codes, quality audits, customer feedback, and implement changes.
We leverage cutting-edge tools such as BI to facilitate automated validation of checks which promotes efficiency and consistency in data. Our streamlined workflow solutions allow us to track the entire process starting from image reception to safe submission of reports. Our entire teleradiology services cover diagnostic tests, uploading images, three layers of review, preliminary report, final report, and final report distribution.
We provide customized solutions to increase salvaged revenues and minimize operating costs and delinquencies, with a single centralized repository of documentation. We set up follow up services on outstanding claims, collections, track claim denial causes, and pending receivable balances. We have an extensive range of service models that allow our clients to choose the one that befits their budget and requirements.
We conduct payment reviews on a periodic basis, track payment patterns to determine any discrepancies in payments. Our responsibilities include writing off the difference between the claim received and the actual claim submitted. We identify instances of denials for medical emergency, denial of authorization of services, non-covered service, among others and initiate measures to prevent their re-occurrence.
We review and analyze all types of records such as hospital & emergency discharge note, admission notification, transition care summary, lab results, hi-tech radiology results, consultation notes, insurance procedure authorization request, medication prior authorization, medical records from outside doctor, referral request from the patient to see a specialist which are fed into software and index with respective label and attach it to patient’s medical chart.
Our team of experts with a clinical background with nurse degree reviews the prescription drug request coming through online portal, through incoming faxes, from patient or from the pharmacy on behalf of patient. They determine the necessity of drugs for the patient and sent the request to doctor approve it. We call pharmacies for any clarification and communicate to patient for further action on dosage or directions.
Our staff coordinate with multiple departments for functions such as appointment reminders for patients, booking or cancellation of appointments. We process both global and procedure referrals by submitting requests through insurance portal or calling the insurance to process the request. Upon approval, the specialist office is duly notified. We also submit the medical records or lab results if it is required from the insurance to approve the authorization number. Our team reviews patient charts to identify quality gaps and proactively address the same. We set up reminders for patients for their yearly pathological tests and also provide follow-up services for patients to clear their dues, medication refill request, DME request, and patent billing clarification.
We verify the insurance E&B prior to the day of a scheduled appointment. This includes capturing details and update in the patient notes – copay, deductible, co-insurance, in-network and out of network benefits, PCP name matching. We follow up with patients in case of any missing information and assist them in addressing the same. We also conduct service procedure check and need of authorization.
Our team comprises doctors credentialed to take over the electronic medical chart in EHR to analyze the reason for the patient visit, review patient history, their current and old medications in the chart, diagnose conditions, and advise lab tests if it is required or if the patient is due. Physicians assess the pre-charted notes at the time of patient arrival and modify the assessment section based on the discussion at the time of encounter and sign the record in the HER.

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Healthcare Back-Office Support Services by MedBillingExperts

Our Success Story in Figures

Claims Processed
Monthly
Client
Retention
Practices
Billing
Companies
Active
Providers

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FAQ's

  • What is HIPAA Compliance?

    In 1996, the US Congress legislated HIPAA (Health Insurance Portability and Accountability Act) to define a necessary national standard for heightened privacy and security of confidential health information...

  • What is Medical Billing Service?

    The following are Medical billing services Pre-certification and verifying insurance, Capturing patient demographics, CPT and ICD-9 coding, Recording charges, Submitting claims, Posting payments...

More FAQs

97%

Clean Claims On First Submission

24/7

Support

100%

HIPAA Compliance

25%

Increase in Collections

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Our Healthcare Software Expertise

Software Tools We Use for Medical Billing and Coding Solutions