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Health Care

Health Care

Together, let’s transform how care is delivered, managed, and paid.

We serve

Together, we work with clients across the healthcare ecosystem to meet their current and dynamic business challenges.

Payers

We help payers improve members’ care quality and network performance, manage population risk, and optimise revenue while decreasing administrative waste and reducing health claim expenditures.

Providers

We help provider organizations proactively manage risk, improve quality outcomes, optimize network performance, and drive member experience.

Patient Scheduling And Appointment Management
RCM SERVICES

Patient Scheduling and Appointment Management

Patient Scheduling and Appointment Management services are designed to help healthcare providers manage their schedules more effectively while improving patient satisfaction. Our services include:

  • Scheduling appointments through the provider's online portal
  • Collecting patient demographics for eligibility and prior authorization requirements
  • Scheduling appointments based on provider availability
  • Sending automated reminders to patients and providers

Eligibility and Benefits Verification

Our skilled team of experts handles the patient’s eligibility verification process. They have the expertise in confirming the patient’s coverage and benefits from individual payer websites and making phone calls. Our services include:

  • Fast and accurate verification of primary and secondary coverage details
  • Efficient connection with the payer using the best possible channels.
  • Obtain a pre-certification number and get approval for benefits verification.
  • Verify patient demographic and policy information, including benefits, deductibles, plan inclusions, and exclusions.
Patient Demographics

Patient Demographics

Establishing a clear and standardized process for collecting patient demographic information helps safeguard against critical mistakes being made at an early juncture.

We update the following patient information on the system:

  • Legal name, gender, address, phone numbers (work/home/mobile)
  • Social security numbers for identification
  • Health insurance information and policy details
  • Medicaid or Medicare policy
  • Contact information for the person who is responsible for payments

Charge Entry

Our charge entry transactions remain consistent throughout:

  • Receive documents in the form of superbills, charge tickets, source documents, etc. through FTP or document management system or client’s system.
  • Capture the date of service, billing provider, referring provider, POS, admission date, CPT/procedure codes, ICD-10, number of units, and modifiers.
  • Using our proprietary tool ARC. Flow provides real-time reporting to the customer by escalating pending issues for clarification which results in faster turnaround time.
  • Import charges directly from the EMR. These charges are reviewed for accuracy before being sent for billing.
our-service

Our Services:

  • Improve productivity and accuracy
  • Ensure appropriate reimbursement collected
  • Identify and fix compliance issues for charge overages
  • Recover lost charges and avoid delay in processing AR.

Payment Posting

We process the following types of remittance transactions:

  • Electronic Remittance Advisory (ERA)
  • Manual Payment Posting
  • Denial Posting
  • Posting Patient Payment
Posting Patient Payment

Accounts Receivable

Accounts receivable (AR) teams are responsible for identifying outstanding balances owed to a provider and taking all necessary steps to ensure that payment is made. AR teams identify outstanding accounts, review them to discover why payment was never made, amend claim errors to resubmit them for payment, and collect from insurers or patients.

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