3. Technomine – An Introduction
Founded in 2008, Technomine is one of the leading ISO 9001:2008 certified Outsourcing
Company, serving clients for USA, UK and other European and Middle East Countries. We
help our clients in staying focused on their core business while we take care of the entire
non-core activities of their organization. Our commitment towards quality and consistent
performance has helped us create value for our clients and become an integral part of their
business process.
Technomine is a ONE STOP SOLUTION for outsourcing business. We primarily service the
Health care domain for Medical Billing/Coding, Revenue Cycle Management, Claims & A/R
Management.
Technomine also renders services for Permanent and Temporary placements of Doctors,
Nurses and other Health Care Professionals.
Accounting and Finance process outsourcing, Recruitment for varied industries inclusive of
construction, Energy, Contracting, Engineering & Manufacturing and IT. We also provide
state of art IT based enterprise solutions to our clients.
With almost a decade of experience and excellence in services, we have successfully
emerged a trusted partner to our clients.
4. Health Care Domain
Technomine is committed to provide professional and State of Art Medical Billing &
Coding and Revenue Management Services to Hospitals, Clinics and other healthcare
providers to navigate and succeed in an increasingly complex reimbursement environment.
Since inception, Technomine has grown as a company with an integrated portfolio of leading
information technology, process, and domain expertise solutions to address the wide array of
threats to the financial health of medical practioners, clinics, hospitals, and other essential providers.
Our approach to Medical Billing/Coding ,Revenue Cycle Management, and Reimbursement is
comprehensive, practical and innovative.
We leverage people, processes, information technology, and services to maximize the financial and
operational performance, and ultimately the clinical performance, of our clients.
12. Low level of collections and large accounts receivable backlogs
Retention and management of billing staff
Lack of qualified personnel and billing resources
Increasing need for IT capital expenditures
Difficulty keeping up with ever-changing claims processing procedures
Lack of follow through on low value claims and with insurance companies on
Credentials, payment, etc.
Rising costs of administration and processing services
Distraction from core business objectives
Challenges
16. TQ Extracts Appointment Schedule 4 days in Prior to Svc.
Date from client’s PMS
Verify Patient’s Ins. coverage & Demographic info with
Insurance
Pat. A/c ‘s with issues are mapped with appropriate status
code
Eligibility Reports forwarded to corresponding site location
Front desk @ site location rectifies the invalid (or) missing
patient. A/c information.
Eligibility Verification
17. Client scans super bills and upload the scanned files on to a
secured server located at client’s office.
Trans-quest downloads the scanned Super-bills and
distribute the files for Coding
Our CPC certified coders analyze each super-bill and code
as per the guidelines set by CMS and AMA
The coded Super-bills are then examined for any possible
errors by a well experienced CPC certified coder
Audited Super-bills are sent to the Charge Entry team to
create claims in Client’s PMS system
Medical Coding
18. Scanned patient’s demographics and the coded Super-bills
are sent to Entry team to create claims in Client’s PMS
system
Each patient’s scanned record is analyzed and
determined if it is a New patient or an Established
patient
If it is a New patient, then create an account in Client’s
PMS system. And update the patient’s A/c if it is an
Established patient.
Create claims in Client’s PMS system based on coded
Super-bills
Thorough audit of claims data to ensure optimal quality
levels prior to claim submission
Patient Registration and Charge Entry
19. Primary & Medicare Secondary Electronic:
Primary & Secondary Medicare electronic claims are submitted directly to Medicare connecting
through the Client’s PMS system from the central billing location.
Care-First and various other commercial Insurance claims are submitted through a clearing house
(Emdeon/Proxy Med).
EDI claim acknowledgement reports are retrieved and analyzed to trace any rejected claims with in
24 hours from transmission.
All rejected claims are resolved by taking corrective actions and re-submitted on the same day.
Paper Claims:
Paper claims are queued on the client’s practice management system so that they are printed on a
CMS 1500 form at the client’s office and mailed to various insurance companies accordingly.
Claim Process Management
20. Scanned EOB’s are downloaded from Client’s office at
Trans-quest and distributed among the Payment posting
team to further process those batches
Payment team will create a batch and set the target
value to be posted in Client’s PMS system
Analyze each EOB and post payments, adjustments or
flag denials in Client’s PMS system as per the scanned
EOB files
Batch log is printed from Client’s PMS system to
reconcile the batch posted and audit transactions by
the posting team
Thorough audit by experienced payment team to
ensure optimal quality levels in transaction posting
Payment Posting and Reconciliation
21. The AR Analyst receives the work order from the Cash
posting department on all the Unpaid / Part paid claims
After analyzing the Unpaid / Part paid claims report,
the Analyst identifies the claims that need to be further
researched allocate the work order to our AR team
A weekly Insurance receivable summary and detailed
report are generated from the Client’s PMS system by
our Analyst team for claims that are 20 days past billed
date
Work orders are then distributed by the Analyst team
based on the Age of the Ins. AR and Filing / Appeal
limits of outstanding claims
The A/R Analyst takes final action on the claims worked
by our AR team and forward reports to client if
additional information is needed to resolve those
balances
Accounts Receivable Management
23. Daily charges are posted in to client’s Billing system with in 18 hrs of receipt
Claims are submitted on the same day the charges are posted in PMS system.
Report to client on any unresolved EDI claim rejections pertaining provider and patient
registration issues.
Same day payment posting & reconciliation in to client’s Billing system with in 18 - 24hrs.
Increase the probability of payment through timely follow-up on accounts having
possibilities for delay in payments and take corrective actions to resolve these claims.
Delivery Model that not only accelerates your cash flow, but also reduce Days in A/R and
also improve Collection Ratio.
Prompt resolution of EDI claim rejections with in 24 hrs from claims transmission date and
resubmit corrected claims.
Technomine Delivery Model
24. Advantages
48 hour turn around time for claim submissions and cash postings
Prompt follow up on every account before 30 days aging to reduce Denials
Dedicated account manager and detailed monthly MIS reporting
Up to 40% reduction in operating costs and up to 20% increase in revenue
Faster collection cycle with Greater than 95% accuracy
Decreased accounts receivable days & financial delays
Improved cash flow owing to experienced billing resources
Highest level of document and data integrity
25. Process to ensure HIPAA Compliance
Employees sign Confidentiality Agreements
Access to information only on a “Need to Know” basis
Excellent Domain Expertise
Certification from AAPC
Active Member of HBMA & MTIA and active participant of MGMA
Leadership Development Programs
Continuous Training and Development
Leverages
26. Streamline your Operations and Workflow
Cash flow increase
Save on the high cost of equipment and software as rapidly changing
technology translates into extra expenses
Reduce staff size and employees expenses
Eliminate sick pay, vacation pay, insurance benefits, workers compensation,
etc.
Eliminate training costs
Reduce call volume
Focus on patient care instead of billing
No cash-flow interruptions due to staff turnover
Reduce costs
Eliminate “non-medical” business office space
Reduce record storage space
Receive detailed reports
Eliminate provider/patient payment discussion
What Difference We Create…..
27. Human
Resources
Quality
Management , Audits
And Reporting
Infrastructure
&Technology
Excellence, Training,
Process and
Regulatory Compliance
Management
Experts
Our Synergy
Process Optimization
and Business
Intelligence
28. INFRASTRUCTURE
Technomine has a very well developed infrastructure. We leave no stone unturned and below are
some salient features of our infrastructure which reflects our commitment to provide a seamless
quality of service and provide a healthy working environment for our employees.
•6000 sq. ft. of operational area
•Certified as a zone 4 earthquake resistant office
•Fire alarm and safety across the entire office
•24 X 7 power supply with back up UPS and generators
•100 Mbps intelligent network powered by Nortel Switch
•Fiber optic based leased line for high speed internet connection
•Recreation facilities
•Separate dining area for the employees
29. SECURITY AND QUALITY
Technomine is an ISO 9001:2008 certified company. We implement the latest and the best
practice followed in the industry to provide a high quality of service and protect the interests of
our clients.
•Secure VPN protected by Sonic WALL TZ 210 firewall
•Digital ID card for all employees to access the office premises
•Restriction on the usage of personal devices (i.e. cell phones, PDAs, Tablets etc.) in the building
•Restricted access of employees to servers
•Separate area for visitors
•Limited access of the internet to prevent unauthorized usage
•Centrally managed anti-virus for data protection and theft
•Passwords and access control across the organization
•SSL protection of servers
•File encryption to prevent data theft
•Non Disclosure Agreement signed by every employee
•Destruction or returning of all data (digital or physical) to the client upon request
30. Technomine Quality Monitoring Services
Technomine offers a complete end to end solution to help you develop the contact
center and its quality monitoring service model for your organization
Quality Assurance is a must for measuring efficiency and effectiveness of business
processes. We at Technomine assist companies in identifying opportunities and
deriving actions to improve their processes, sales conversion and customer
satisfaction.
We also provide intelligent data with the help of our Contact Center Quality
Monitoring program that produces insight which will drive business improvements.
An effective quality assurance model and plan help us deliver better sales results,
improve customer experience and also ensure all regulatory and compliance
requirements defined by the clients are met consistently.
360 Degree Quality monitoring Services for Contact Centers and Captives
(Quality monitoring of Inbound/Outbound interaction)
Voice
Web Interaction
31. Transactional Monitoring & Teams compliance to GDS/CRM, sales, and service policies
Customer Service Improvisation
Customer Experience Survey scrub
Customized Agent level Coaching and Feedbacks
Market intelligence based on chats, calls and emails from customers
Process compliance audits
Sales Verification & Sentiment Analysis
TQMS online platform for quality monitoring and data analytics to ensure Real time Reports
Socially Enabled Center
Technomine Quality Monitoring Services
32. QC
•Interactions will be monitored by QCs
•Direct feedback of each interaction will be sent to particular agent
QA
•Weekly interactions will be checked and analyzed by QA for the agents and team
•Weekly/monthly generalized feedback will be sent to clients for the teams and agents
ATA
•Sample Interactions checked by QCs and QAs will be checked by ATAs to maintain QC’s Quality
•All the analytical reports and disputes will be rechecked by ATAs and then only sent to Quality
Leaders
Quality
Leaders
•All the reports and analytics will be finally checked by Quality Leaders
•Then Quality Leaders will send those reports, QBR and analytics to the end Clients
Multi Layer QMS Integration
33. Quality Assurance and Six Sigma
• Collection of data:
Check and gather
data from the
outcome of
implementation,
whether it is helping
clients to improve
their customer
satisfaction level
• Evaluate and
Review: Take the
outcomes from the
data and implement
the positive one and
work on the
negative one in next
planning
• Develop and pilot
plans: Training
agents according
to that SOPs and
policies so that
they follow it
properly
• Create possible
solutions and
selection of
solution:
Designing of the
quality parameter,
scorecard , SOPs,
and policies
Plan Do
CheckAct
34. 2
3
4
5
6
1 Deep expertise and experience in serving the healthcare industry
Passion for achieving the highest level of quality
Broad understanding of clients’ long and short term goals
Focus on building partner relationships
Emphasis on ingenuity to achieve maximum cost savings
Documented ability to deliver on time and according to specifications
Differentiator
