FAQs on Outsourcing Medical Claims

Outsource your medical accounts receivables management to India and transform your pending medical claims to cash. The cash flow thus generated plays a significant role in achieving a healthy revenue stream every month. This is a critical factor as the business budgeting and planning is based on the cash flow generated by the accounts receivables team.

Besides collecting claims, identifying uncollected claims and transforming them into cash is an important responsibility of the accounts receivables team. If problem accounts are not dealt with adequate resolution measures, their status will slide to uncollectable.

Our medical claims processing services will lower your fixed costs by up to 40%. Besides minimizing denials, we also file claims and follow-up with the insurer until recovery of your dues. Read further to gain a deep insight into our hospital accounting services.

At MedBillingExperts, our medical claims processing professionals follow a well-structured, meticulous receivables management process to achieve maximum claims approvals. To learn more about our medical account management process, click here.

In addition, we have implemented process improvement best practices. On receiving the claims denial report from the payer which specifies the cause of denial, we modify our processes and employee training programs accordingly to prevent such medical claims denials in future. When a payer denies payment or makes an underpayment, we register an appeal with the requisite rectifications.

Our appeals registration process is as follows:

• We track our medical claims recovery performance by measuring both the denial rate and the turnaround time end-to-end—from claims filing to payments recovery.
• We have implemented a system to minimize and track the appeals submission time. We have also created standard appeals letter templates that are easily customizable with the patient data and denial cause rectification information.
• We do not register appeals for very low dollar claims. Hence we have established minimum thresholds of $10 for the first appeal and $20 for the subsequent one.
• If claims are habitually down-coded by an insurance company, we appeal for the originally submitted code and attach supporting documents.
• If an insurance company consistently denies payment for a specific code, we request physicians to personally meet and discuss the issue with the insurance company while carry supporting documents, instead of registering appeals repeatedly.
• Before signing a contractual agreement with any payer, we urge physicians to gain complete clarity on the claims appeal process. This helps us determine our strategy for tackling denials and to draw up plans for further action.
• Further action includes steps such as ascertaining whether mediation is permitted, grievance hearings held, physician peer review requests accepted in case of denials for medical necessity etc.

Though appeal strategies are not always successful, it is observed that at least 50% appeals do get approved. Such returns are well worth the effort and time invested in pursuing appeals, especially if the appeals process is executed efficiently by the accounts receivables team.

Our charges range between 4%—4.5% of your healthcare center’s monthly revenue.

• Please fill our inquiry form and our staff will contact you through phone or e-mail.
• We will assess your requirements and provide cost estimates. You may contact our customers for reference checks.
• We execute a free trial. Once you approve our quality, we then create and sign an agreement and begin work.
• We rapidly deliver a pilot phase to enable joint resolution of any problems and quickly improve the final result.

Our key differentiating factor probably is that we lay great emphasis on understanding client requirements through effective communication. To confirm this, just fill-up our inquiry form on this site.

This is the vital question that we ask potential candidates before hiring and also the one to be asked of an Indian vendor.

MedBillingExperts was an early starter in the outsourcing spectacle and gained a solid reputation quickly.

We have acquired a wide base of long-term customers primarily located in the US and the UK. These include healthcare centers, medical billing firms and a host of international enterprises.

Having multiple dedicated business units enables us to handle varied activities in-house. For example, we possess the ability to migrate software data from one technology to another viz. PHP to MS.NET. Our DTP experts can transform from Quark to InDesign. We are capable of offering several more services all of which may not be listed here.

If you are looking for top quality, customized medical account management services then you should consider India as an outsourcing destination. Learn more about our modern infrastructure, core competencies, competitive pricing and wide array of benefits.

If you want to obtain more information on outsource medical claims services to India, please fill-up our inquiry form and our client engagement professionals will contact your office within 24 hours.