Flatworld Billing Services


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Flatworld Billing Services

  1. 1. MEDICAL BILLING SERVICES © Flatworld Solutions, Inc. 2009
  2. 2. AGENDA <ul><li>History Of Rapid Growth </li></ul><ul><li>Corporate Profile </li></ul><ul><li>Global Delivery Model </li></ul><ul><li>Flatworld Client Locations </li></ul><ul><li>Service Offerings </li></ul><ul><li>People </li></ul><ul><li>Practice Management Software </li></ul><ul><li>Process Transition </li></ul><ul><li>Reporting </li></ul><ul><li>Why Flatworld? </li></ul><ul><li>HIPAA @ Flatworld </li></ul><ul><li>Security </li></ul><ul><li>Other Services </li></ul><ul><li>Flatworld Infrastructure </li></ul><ul><li>Flatworld Facilities </li></ul>© Flatworld Solutions, Inc. 2009
  3. 3. <ul><li>Flatworld Solutions is headquartered in the Silicon Valley of India, Bangalore, famous the world over for being the hub of outsourcing activity. </li></ul><ul><li>Our customers are located in the US, Canada, UK, Norway, France, Australia, The Netherlands, Switzerland, Israel, India, Sweden, Germany and UAE. </li></ul><ul><li>Our global delivery centres are located in Bangalore (multiple locations), Chennai (multiple locations), Coimbatore, Trichur, Mumbai, Philippines, Peru, Bolivia, Colombia, Paraguay, Mexico and Kenya. </li></ul>A HISTORY OF RAPID GROWTH © Flatworld Solutions, Inc. 2009
  4. 4. CORPORATE PROFILE <ul><li>Over 10 years of US Healthcare Experience </li></ul><ul><li>Registered offices in US, UK and India </li></ul><ul><li>Current strength of over 70 Billing Specialists and Receivables Specialists. </li></ul><ul><li>Multiple delivery centers offering redundancy </li></ul><ul><li>Leading Provider in Billing, Teleradiology, Transcription and Software Solutions </li></ul>© Flatworld Solutions, Inc. 2009
  5. 5. GDC-Argentina Cordoba GDC-Chile Santiago GDC-INDIA Bangalore, Mumbai, Chennai, Coimbatore, Pune, Trichur GDC-The Philippines Cebu City GDC-Bolivia La Paz & Santa Cruz GDC-Peru Lima GDC-Kenya Nairobi GLOBAL DELIVERY MODEL harnessing the world’s best resources for you… © Flatworld Solutions, Inc. 2009 GDC-Mexico GDC-Paraguay GDC-Colombia
  6. 6. MEDICAL BILLING CLIENT LOCATIONS Flatworld coverage in US © Flatworld Solutions, Inc. 2009
  7. 7. SERVICE OFFERINGS © Flatworld Solutions, Inc. 2009
  8. 8. PEOPLE <ul><li>Operations headed by a Manager with 15 yrs of experience. </li></ul><ul><li>Operations Manager in industry since off-shoring trend of RCM 1994. </li></ul><ul><li>Over 70 Medical Billing and Accounts Receivables Specialists. </li></ul><ul><li>Coders, Billers & AR specialists have average experience of 3 years. </li></ul><ul><li>1/3rd of the professionals are post-graduates and the rest graduates. </li></ul><ul><li>Cross training on multiple specialties and PMS. </li></ul>© Flatworld Solutions, Inc. 2009
  9. 9. SPECIALTIES <ul><li>Internal Medicine </li></ul><ul><li>Ambulance </li></ul><ul><li>Chiropractic </li></ul><ul><li>Physical therapy </li></ul><ul><li>Gastroenterology </li></ul><ul><li>Pediatrics </li></ul><ul><li>OBGYN </li></ul><ul><li>Urgent Care </li></ul><ul><li>Rheumatology </li></ul><ul><li>Endocrinology </li></ul><ul><li>Podiatry </li></ul><ul><li>Pathology </li></ul><ul><li>Ophthalmology </li></ul><ul><li>Anesthesiology </li></ul><ul><li>Psychiatry </li></ul><ul><li>Skilled Nursing Facility </li></ul><ul><li>Cardiology </li></ul><ul><li>Pediatric Neurology </li></ul><ul><li>Pediatric Nephrology </li></ul><ul><li>Orthopedic </li></ul><ul><li>Emergency Room </li></ul>© Flatworld Solutions, Inc. 2009
  10. 10. PRACTICE MANAGEMENT SOFTWARE © Flatworld Solutions, Inc. 2009
  11. 11. Requirement Analysis Pricing & Contracting Project Initiation Project Steady State Ramp-up PROCESS TRANSITION © Flatworld Solutions, Inc. 2009
  12. 12. REPORTING © Flatworld Solutions, Inc. 2009 SCAN CONTROL LOG (CHARGES) – Daily Report Gives details about the # of pages received, # of charges and demos received on a day to day basis, how many completed, how many pending and the date completed SCAN CONTROL LOG (PAYMENTS) – Daily Report Gives details about the # of pages received on a day to day basis, value of payments received, how much posted & how much un-posted & the date completed . PENDING LOG  (CHARGES) – Daily Report Report Description: Gives details about the claims which require some clarification from client on the Patient Demographic or on the Encounter form. Field Names: Name of the batch, date when file was sent by client, patient name, DOS, Reason for pending & client comments. In the Client Comment section, the Client need to enter their comments and send us back the excel sheet to clear the pending issue.
  13. 13. REPORTING © Flatworld Solutions, Inc. 2009 PENDING LOG  (PAYMENTS)– Daily Report Report Description: Gives details about the claims which require clarification from client on the EOBs. Field Names: Name of the batch, page number, the patient name, chart number, date of service and the reason for pending. It also has a “REMARKS” section where the Client needs to enter their comments and send us back the excel sheet to clear the pending issue. A/R REPORT- Weekly Report Report Description: This report will let the client know about the work FLATWORLD did for a week in terms of AR follow up. The # of calls made by the agent with the representatives of the insurance & the action to be taken for the claim. Field Names: Chart number, patient name, DOS, Insurance to whom the call was made, Total charges,  balance outstanding, the comments/notes i.e. the conversation between the caller and the insurance agent and the action needed to be taken on the claim and finally the action code
  14. 14. Why FLATWORLD <ul><li>Knowledge of working with all insurance payors including Medicare & Medicaid </li></ul><ul><li>24/5 Operations </li></ul><ul><li>State of the art infrastructure </li></ul><ul><li>Elimination of hire-replace-train process </li></ul><ul><li>Knowledge retention </li></ul><ul><li>High employee retention rates – 92% in 2008 </li></ul><ul><li>Accessible via toll free number 8AM-5PM Mon-Fri during US Business hours </li></ul>© Flatworld Solutions, Inc. 2009
  15. 15. Why FLATWORLD <ul><li>Reduction in Operational Costs up to 40-50% </li></ul><ul><li>Highly experienced Billing and AR Specialists </li></ul><ul><li>Coders certified by AAPC </li></ul><ul><li>Clean Claims, Fewer Denials </li></ul><ul><li>Follow-up on all claims not paid within 30 days </li></ul><ul><li>Guaranteed Improvement in Collections </li></ul><ul><li>Daily, Weekly and Monthly Reports </li></ul>© Flatworld Solutions, Inc. 2009
  16. 16. HIPAA @ FLATWORLD <ul><li>Privacy </li></ul><ul><li>Every staff member signs a confidentiality agreement. </li></ul><ul><li>Client information access to staff is password protected and is provided on an ‘as-needed’ basis </li></ul><ul><li>Records of data access are maintained and supervised by an authorized security officer </li></ul><ul><li>All the documents received from the client are handled in electronic format. </li></ul><ul><li>Documents are not printed at Flatworld facilities. </li></ul><ul><li>Accessibility to external storage device is denied </li></ul>© Flatworld Solutions, Inc. 2009
  17. 17. HIPAA @ FLATWORLD <ul><li>Security </li></ul><ul><li>Access to Flatworld is provided only via a secure VPN connection using firewall </li></ul><ul><li>Data is encrypted before transmission </li></ul><ul><li>Data is frequently backed up and stored </li></ul><ul><li>Access to the organizations’ information system is controlled through proper authorization, establishment and modification to access </li></ul><ul><li>Record of access authorization is maintained. </li></ul><ul><li>Controlled access to the stored data to accredited individuals to ensure accountability of all transactions </li></ul>© Flatworld Solutions, Inc. 2009
  18. 18. SECURITY It is a process driven approach that significantly enhance the security of our IT infrastructure from internal and external threats using researched processes, procedures and tools. © Flatworld Solutions, Inc. 2009 People Process Technology Prevention Detection Response <ul><li>Awareness </li></ul><ul><li>Commitment </li></ul><ul><li>Action </li></ul><ul><li>Plan </li></ul><ul><li>Enforce </li></ul><ul><li>Check </li></ul><ul><li>Improve </li></ul><ul><li>Systems </li></ul><ul><li>Network </li></ul><ul><li>Applications </li></ul><ul><li>Tools </li></ul><ul><li>Authentication </li></ul><ul><li>Identification </li></ul><ul><li>Authorization </li></ul><ul><li>Access Control </li></ul><ul><li>Confidentiality </li></ul><ul><li>Integrity </li></ul><ul><li>Accountability </li></ul><ul><li>Audit </li></ul><ul><li>Intrusion Detection </li></ul><ul><li>Non Repudiation </li></ul><ul><li>Availability </li></ul><ul><li>Triage </li></ul><ul><li>Recovery </li></ul><ul><li>Reliability </li></ul><ul><li>Corrective Action </li></ul>
  19. 19. OTHER SERVICES <ul><li>INDEXING MEDICAL RECORDS INTO AN EMR </li></ul><ul><li>TELERADIOLOGY SERVICES </li></ul><ul><li>MEDICAL ANIMATION AND ILLUSTRATION SERVICES </li></ul><ul><li>TELERADIOLOGY SERVICES </li></ul><ul><ul><li>Certified Reporting by US Board Certified, Licensed Radiologists </li></ul></ul><ul><ul><li>Preliminary Reporting by Indian MD Radiologists </li></ul></ul>© Flatworld Solutions, Inc. 2009
  20. 20. POWER & NETWORK Generator UPS 1 2 3 UPS (servers) Electricity Power <ul><li>3 levels of redundancy </li></ul><ul><li>Primary Source – Available 500 KVA </li></ul><ul><li> – Facility Load 300KVA </li></ul><ul><li>Generator Backup – 450 KVA generator with fuel Storage for 24 hrs operation onsite with arrangements to sustain </li></ul><ul><li>UPS Network Centre – 1 X 60KVA (Redundant) </li></ul><ul><li>UPS Overall – 4 X 160KVA </li></ul><ul><li>All devices are with dual power supply and fed thru independent power paths. </li></ul><ul><li>3 tier architecture </li></ul><ul><li>Redundant L3 Core design </li></ul><ul><li>Servers terminate into the core through redundant connectivity </li></ul><ul><li>Redundant workgroup switches (with L3 capability) per floor collapses into the Core </li></ul><ul><li>Network fabric with port level physical redundancy </li></ul><ul><li>150 active ports per floor </li></ul>
  22. 22. WEBSITES www.outsource2india.com | www.nabler.com | www.flatworldsolutions.com © Flatworld Solutions, Inc. 2009
  23. 23. THANK YOU Flatworld Solutions, Inc. Princeton Forrestal Village 116 Village Blvd, Suite 200 Princeton, NJ 08540 P +1- 213 784 5651 | F +1 646 619 4979 | ajit@flatworldsolutions.com © Flatworld Solutions, Inc. 2009