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Pranagy Med RCM

Pranagy Med RCM



PranagyMed RCM

PranagyMed RCM



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    Pranagy Med RCM Pranagy Med RCM Presentation Transcript

    • Welcome to PranagyMed Single-Source for Healthcare Business Solutions™
    • Our Value Proposition
      • Leveraging our excellent domain knowledge, people’s talent, advanced technology and industry’s best practices to:
      • Reduce the cost and improve the quality of healthcare back office operations
      • Deliver low risk and high value services consistently to our clients
      • Deliver long term benefits and measurable results to our clients
    • End to End Revenue Cycle Management Payment/Denials Posting Appeals Coding Audits & Physician’s Education Medical Coding Demographics Entry Insurance Follow-up Charge Entry Secondary/Patient Billing Denials Resolution Claim Generation & Submission Patient Follow-up Patient’s Helpdesk Insurance Pre-verification Long and successful experience of managing large & complex client engagements in end to end RCM operations proves the reliability and quality of our service delivery Our Service Offerings Medical Transcription
    • World Class Quality Strong Healthcare Domain and Industry Knowledge Experience serving the Global Healthcare Leaders 7x24 Operations to Minimize the TAT Highly Flexible: Collaborative Sourcing One Stop Shop with a Broad Profile of Healthcare Service Offerings Significant Cost Savings along with improved quality Critical Mass of Technology and Domain Experts PranagyMed Our Advantage
    • About PranagyMed
      • Proven Track Record of 8+ years in outsourcing in medical transcription, coding, billing and AR follow up services
      • Providing medical coding, billing and AR services to more than 200 healthcare providers across the US
      • One of the strongest healthcare outsourcing service delivery team with more than 600 years total healthcare RCM experience
      • State of the art 12,000+ sq ft service delivery center owned by the company
    • . . North Carolina, USA Noida, New Delhi, India Coimbatore, India . . Perth, Australia San Diego, USA . Our Global Offices . Florida, USA
    • Medical Transcription Services
      • Dictations from Medical Practices
      • Processed into digital audios
      • Sent to back office over encrypted FTP directories 
      • Dynamic work allocation; job assignment through distribution software 
      • Medical Transcriptionists process audio files and convert them into word documents
      • Final reports are delivered simultaneously over encrypted path to Coding Division and Medical Practice/Client.
      Standard Process Flow
    • Medical Transcription Services
      • Experienced MTs and QAs: Each MT has at least 2-year experience and Each QA has a minimum total industry experience of 4-5 years with maximum experience ranging up to 8-9 years. Our end-product transcribed documents bear a proven minimum accuracy of 98.5%.
      • Wide Exposure: We have exposure to all types of work types, History & Physical, Operative Notes, Radiology Notes, Consultation Notes, Discharge Summaries, Medicolegal Evaluations, etc.
      • Compulsory Three levels of transcription to ensure quality/accuracy.
      • Client documents like Physician Lists, Client-Specific Guidelines, Templates, and Policies are followed without fail in keeping with latest updates from clients. These documents are updated and maintained whenever required.
      • Resources used for transcription are latest up-to-date physical & electronic books like Stedman’s, AHD, QuickLook, etc.
      Our Competencies and Accuracy
    • Medical Coding Services
        • Evaluation and management
        • Cardiology
        • Emergency Room
        • Orthopedics
        • Neurology
        • Urology
        • Pathology
        • Gastroenterology
      Specialties Covered
      • Physician audits
      • Facility Acuity Level Audits
      • Physician Education
      • Working on system generated edits
      • Working on rejected claims, appealing cases where appropriate
      Medical Coding Audits Denials Management Cross Section of the Coding Team
      • We have a highly skilled and qualified team of professionals from various medical and paramedical backgrounds which gives us a definite edge in the dynamic field of coding
        • Physicians ,Nurses, Physiotherapists, Pharmacists, Lab technicians, Medical Transcriptionists, Medical Record specialists and other Paramedical professionals
        • Oncology
        • ASC
        • Anesthesia
        • General Surgery
        • Diagnostic Radiology
        • Interventional Radiology
        • Psychiatry
        • Otorhinolaryngology
    • Salient Feature & Competencies – Demographics, Charge, Payments
      • Dedicated team for each client engagement as virtual extension of client’s office. Team members are not shared between clients
      • Function specific teams (separate teams for charge entry, payment posting etc.) builds functional expertise among team members, enables more effective, error free service delivery to our clients
      • Claims are scrubbed and validated for data accuracy and completeness before submission to insurance. Dedicated team to resolve claims edits during scrubbing process to submit only the clean claims for faster payments and to avoid denials
      • Demographics and Charge entry team generates claims worth more than USD 80 millions and submits to insurances every month
      • Payment Posting team posts payments worth more than US $ 63 millions every month in patient’s accounts. Secondary and Patient billing done by payment posting team
      RCM - Data Entry Functions
    • Salient Features & Competencies – AR
      • AR team follows-up on claims across all the insurances to resolve denials including government insurances, commercial carriers, BCBS, worker’s compensation and no fault
      • Detailed analysis of denials to identify and solve the global issues resulting in to improved the gross collection percentage and reduced the AR days
      • Well versed with appeal procedures of different insurances to get those claims paid which are otherwise un-collectable
      • Dedicated team for insurance pre-verification to avoid denials like policy terminated, patient not found, services denied for no authorization/referral, COB denials etc., helps to increase revenues by more than 30% in most cases
      • Expertise in patient calling for statements reminder/soft collections
      • Patient Help-Desk facility to attend patient’s calls and solve their queries
      RCM - AR Functions
    • Introduction Proposed Solution Key Processes Outsourced Benefits to client The client is a large billing company providing RCM services in diversified medical specialties
      • Off shoring of RCM services to India in a pre-defined timeline so that client can focus on developing business
      • Process enhancements for maximum outsourcing gains
      • Continuous Benchmarking
      • Client to retain key employees in-house for regular monitoring and better control
      • Client’s operating cost reduced by 32%
      • Quality and productivity improved to more than 98% across all functions.
      • Reduced turn around time across all functions of the RCM
      • Added benefits
      • Client acquired more business by focusing on core competency, taken up many other physicians
      • The client diversified into multiple specialties of coding as well as auditing
      • We do coding audits and provider education to improve documentation; further increasing revenues and avoiding denials.
      Issues being faced by client
      • Medical coding
      • Demographic entry
      • Charge posting
      • Payment posting
      Client Testimonial “ I just told my CEO that my confidence level has increased 100%. xxxxx told me to review 10-20% now instead of 100%. Your team is doing an amazing job and I am so thankful to each one of you” - Coding and Compliance Officer of the Client
      • Denial handling
      • A/R follow up
      • Appeals
      • Patient Billing & Collections
      • High in-house operating cost
      • Lower quality and productivity of in-house staff
      • Low collections from insurance companies
      • High attrition rates in client’s office
      • High turn around time
      Case Study for a Medical Billing Company Our Advantage
    • Variable cost reduced by 30% Fixed cost reduced by 2% Total value creation for the client in terms of monetary value – 32% Reduced TAT to 24 hours from 72 hours Increased quality to 98%+ Increased productivity by 14% Quantifiable Benefits Typical Benefits for our Clients Our Advantage
    • Single-Source for Healthcare Business Solutions™ Thank you