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Talisman Medical Billing Services


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Revenue Cycle Management services by Talisman Solutions

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Talisman Medical Billing Services

  1. 1. Talisman Solutions Inc Intelligent Solutions Excellent Results RCM / Medical Billing Services
  2. 2. Agenda <ul><li>Talisman Introduction </li></ul><ul><li>Common Pain-points </li></ul><ul><li>Talisman Advantages </li></ul><ul><li>RCM (Revenue Cycle Management) Activities </li></ul><ul><li>Talisman RCM Offerings </li></ul><ul><li>Talisman RCM Process Flow </li></ul><ul><li>Information exchange options </li></ul><ul><li>Talisman Quality Assurance Process </li></ul><ul><li>Security & HIPAA Compliance </li></ul><ul><li>Coding Services/Process </li></ul><ul><li>Software Product Offerings </li></ul><ul><li>Q & A </li></ul>
  3. 3. Company Introduction
  4. 4. About Us <ul><li>Utilizing years of experience and unique blend of healthcare business, process, and IT technical skills our team has proven track record of implementing intelligent solutions and delivering excellent results at minimal cost. We specialize in RCM, Medical Billing, Medical Transcription, EMR, PHR, Custom Software development, product implementation, and other services. </li></ul><ul><li>Core Values </li></ul><ul><ul><li>Outside-In approach – Customer Focus. </li></ul></ul><ul><ul><li>Quality – Established Reputation for Quality. </li></ul></ul><ul><ul><li>Security and Safety of Data. </li></ul></ul><ul><ul><li>Minimal Operation Costs – Save every penny. </li></ul></ul><ul><ul><li>Speed and Flexibility - get the job done. </li></ul></ul><ul><ul><li>Kaizen – Continuous Improvement to Maximize Productivity and Quality. </li></ul></ul><ul><ul><li>Learning Organization – Every employee continuously learns and grows. </li></ul></ul><ul><ul><li>Fun loving work culture </li></ul></ul><ul><li>Mission Statement </li></ul><ul><ul><li>To proactively enable clients to focus more on their core activities by successfully owning up business activities on their behalf in an efficient, effective and persistent way and bringing value to the relationship by successfully leveraging our domain and technical expertise. </li></ul></ul>
  5. 5. History & Identification <ul><li>History </li></ul><ul><ul><li>Talisman Solutions has been serving clients since 2004 and has grown consistently because of our excellent customer service, quality delivery, and reasonable cost. We work with numerous organizations in various geographic across North America, Europe, and Asia. </li></ul></ul><ul><li>Identification & Information </li></ul><ul><ul><li>Company Name: Talisman Solutions, Inc </li></ul></ul><ul><ul><li>Address: 2000 Town Center, Ste 1900, Southfield, MI 48075 </li></ul></ul><ul><ul><li>Entity Organization: Corporation </li></ul></ul><ul><ul><li>State Of Incorporation: Michigan </li></ul></ul><ul><ul><li>Name Changed: Never </li></ul></ul><ul><li>Accreditation </li></ul><ul><ul><li>Better Business Bureau </li></ul></ul><ul><ul><li>American Medical Billing Association </li></ul></ul>
  6. 6. Common Pain-Points
  7. 7. Business Issues/Challenges <ul><li>Changing regulatory environment </li></ul><ul><ul><li>Government policies </li></ul></ul><ul><ul><li>Legal and Compliance issues </li></ul></ul><ul><li>Profitability </li></ul><ul><ul><li>How to lower fixed and variable costs </li></ul></ul><ul><ul><li>How to improve cash flow </li></ul></ul><ul><ul><li>How to minimize bad debt </li></ul></ul><ul><li>Inefficiencies </li></ul><ul><ul><li>Lot of paper documents </li></ul></ul><ul><ul><li>Inexperienced/Untrained staff </li></ul></ul><ul><ul><li>Managing assets, equipment, and inventory </li></ul></ul><ul><li>Stagnant Revenue </li></ul><ul><ul><li>How to increase patient base </li></ul></ul><ul><ul><li>Stay ahead of competition </li></ul></ul>
  8. 8. Business Issues/Challenges <ul><li>Workforce </li></ul><ul><ul><li>How to attract and retain best talent </li></ul></ul><ul><ul><li>Man power issues/work force shortage </li></ul></ul><ul><ul><li>Resource waste </li></ul></ul><ul><ul><li>Optimizing resource utilization </li></ul></ul><ul><li>Management </li></ul><ul><ul><li>Lack of transparency </li></ul></ul><ul><ul><li>Lack of visibility on the Hospital/Clinic progress </li></ul></ul><ul><li>Legal Obligations </li></ul><ul><ul><li>Paying fines for keeping expired medicines un-knowingly </li></ul></ul><ul><ul><li>Emergency preparedness </li></ul></ul><ul><li>Patient Care </li></ul><ul><ul><li>Quality of patient care </li></ul></ul><ul><ul><li>Patient records and history </li></ul></ul><ul><ul><li>Cleanliness in the practice </li></ul></ul><ul><ul><li>Managing Referrals </li></ul></ul>
  9. 9. Talisman Advantage
  10. 10. Talisman Advantages <ul><li>Complete Healthcare Solutions Provider </li></ul><ul><ul><li>Healthcare Products – EMR, HIS, etc </li></ul></ul><ul><ul><li>Healthcare Services – billing, transcription etc. </li></ul></ul><ul><li>Best in Industry collection Rates </li></ul><ul><ul><li>Aggressive - Go after every penny </li></ul></ul><ul><ul><li>All claims filed with payers within 24 hours </li></ul></ul><ul><li>Best value in industry </li></ul><ul><ul><li>Very reasonable cost for quality of service </li></ul></ul><ul><ul><li>No fixed cost; you only pay for the service if you use it </li></ul></ul><ul><li>Expertise </li></ul><ul><ul><li>Excellent knowledge of various insurance billing processes </li></ul></ul><ul><ul><li>Well established quality assurance process </li></ul></ul><ul><ul><li>Experienced, educated, and Knowledgeable workforce </li></ul></ul><ul><ul><li>Continuous stress on trainings and skills upgrades </li></ul></ul><ul><li>Exceptional service </li></ul><ul><ul><li>Dedicated account manager assigned to each account </li></ul></ul><ul><ul><li>Support available through toll free phone, email, chat, etc </li></ul></ul>Cost Efficiency Quality
  11. 11. Talisman Advantages (Cont…) <ul><li>Secure & HIPPA Compliant </li></ul><ul><ul><li>100% HIPPA compliant. </li></ul></ul><ul><ul><li>Free secured email & Secured FTP account </li></ul></ul><ul><li>Knowledge Sharing with Client </li></ul><ul><ul><li>Free consultation and education sessions for client’s staff </li></ul></ul><ul><li>Zero cost Liabilities </li></ul><ul><ul><li>No employee costs – no healthcare, training, vacation, pension, etc </li></ul></ul><ul><ul><li>No software or hardware costs </li></ul></ul><ul><li>Free Trial & Non-binding agreement </li></ul><ul><ul><li>See for yourself where we stand on our quality and cost commitment. </li></ul></ul><ul><ul><li>You can stop the service at any time </li></ul></ul><ul><li>Easy Integration </li></ul><ul><ul><li>Expertise in integrating with any in-house EMR or any other system. </li></ul></ul><ul><li>Flexibility </li></ul><ul><ul><li>Pick & choose services to suit your practice and budget </li></ul></ul><ul><ul><li>We can either work with your software or our own </li></ul></ul><ul><li>Scalable Solution </li></ul><ul><ul><li>Handle volume surges and seasonal changes efficiently </li></ul></ul>
  12. 12. Facts & Figures Customer Satisfaction Collection Rates
  13. 13. Facts & Figures (Cont…) Additional Services Kay Differentiators
  14. 14. Billing / Revenue Cycle Management Services
  15. 15. RCM Activities
  16. 16. Talisman RCM Offerings <ul><li>Front End Services </li></ul><ul><ul><li>Appointment scheduling and confirmations </li></ul></ul><ul><ul><li>Patient Demographic Entry </li></ul></ul><ul><ul><li>Insurance Detail Entry </li></ul></ul><ul><ul><li>Insurance Verification </li></ul></ul><ul><ul><li>Pre certification/authorization </li></ul></ul><ul><li>Billing Services </li></ul><ul><ul><li>Charge Posting </li></ul></ul><ul><ul><li>QR and filing claims with payers </li></ul></ul><ul><ul><li>Payment Posting and Adjustments </li></ul></ul><ul><ul><li>Claim re-filing if required </li></ul></ul><ul><ul><li>Filing secondary claims </li></ul></ul><ul><ul><li>Appeals </li></ul></ul><ul><ul><li>Accounts Reconciliation </li></ul></ul><ul><li>Payer AR Services </li></ul><ul><ul><li>AR follow-up </li></ul></ul><ul><ul><li>Denial Management </li></ul></ul>
  17. 17. Talisman RCM Offerings (Cont…) <ul><li>Medical Coding Services </li></ul><ul><ul><li>Assigning CPT-4, CDT, HCPCS, ICD-9, LCD/NDC as and when required </li></ul></ul><ul><li>Patient Billing & Collections </li></ul><ul><ul><li>Patient Statements/Notices </li></ul></ul><ul><ul><li>Patient follow-ups & Collections </li></ul></ul><ul><li>Reports </li></ul><ul><ul><li>Standard and Custom reports provided bi-weekly, monthly, and annual basis </li></ul></ul><ul><ul><li>Insurance Aging, Patient Ledger, Revenue analysis, AR log, and many others </li></ul></ul><ul><ul><li>Separate analysis reports for each provider in facility </li></ul></ul><ul><li>Healthcare Software </li></ul><ul><ul><li>Electronic Medical Records, Electronic Patient Records </li></ul></ul><ul><ul><li>Patient Health Records </li></ul></ul><ul><ul><li>Hospital Management System </li></ul></ul><ul><li>Other Services </li></ul><ul><ul><li>Medical Transcription Services </li></ul></ul><ul><ul><li>Healthcare IT Consultancy and Implementation </li></ul></ul>
  18. 18. Talisman RCM Process Flow PATIENTS INSURANCE COMPANIES All starts & ends with the hospitals & the physicians TSI MEDICAL BILLING CENTRE Bank TSI Collection Service Centre TSI Collection Service Centre Electronic Claims Paper Claims Misc. Correspondence Electronic Claims EOB & Payments Statements Payment & Billing Enquiries Misc. Correspondence Insurance EOB s Patient Information, charges, payments and denials Patient & Insurance payments deposits Patient Visits Patient Payments Patient Payments Delinquent Accounts Additional Collection Attempts
  19. 19. Information Exchange Options <ul><li>Numerous information exchange options are available to clients: </li></ul><ul><li>Remote Login onto facility network </li></ul><ul><ul><li>No transfer required; our team logs into client network and words same as on-site employee </li></ul></ul><ul><li>On-Site representative </li></ul><ul><ul><li>Our representative is sitting with client in their location </li></ul></ul><ul><li>Entry into HMS, EMR, EHR, PHR, or any other system </li></ul><ul><ul><li>Client enters information in their system, we log into the system and access the information ourselves </li></ul></ul><ul><li>Faxing Documents (Toll Free fax number) </li></ul><ul><ul><li>Client faxes the documents to our toll-free electronic fax system </li></ul></ul><ul><li>Automated transfer using our Secured FTP server </li></ul><ul><ul><li>Information is automatically transferred from client machine to our server. </li></ul></ul><ul><li>Secured Email on computer </li></ul><ul><ul><li>We provide HIPAA compliant secured email account to all our clients, which is used to communicate any PHI/confidential information </li></ul></ul><ul><li>Custom Online system </li></ul><ul><ul><li>We create online forms customized to your needs </li></ul></ul><ul><li>paper records US mail – we do the data entry into the system </li></ul><ul><ul><li>Old paper records can be sent to our office and our staff would enter those in the system. </li></ul></ul><ul><li>Automated Scanner </li></ul>
  20. 20. Talisman Quality Assurance Process <ul><li>Talisman has well-established, seasoned, and repeatable quality control process that ensures excellent quality, high productivity, and maximum collection rates for clients. Some steps followed as part of QR process are: </li></ul><ul><li>Review all claims before submission </li></ul><ul><ul><li>To minimize error rates and denials, the team leader reviews all claims before submission. </li></ul></ul><ul><li>Claims Audit </li></ul><ul><ul><li>Auditor/Manager randomly audits the claims to verify accuracy and compliance. </li></ul></ul><ul><li>Strict Quality Control standards </li></ul><ul><ul><li>Our team has assimilated years of lessons learned into the standards booklet. </li></ul></ul><ul><ul><li>Every employee is regularly trained on the quality standards </li></ul></ul><ul><li>Review log and knowledge database </li></ul><ul><ul><li>Issues and denials are regularly triaged and the reasons captured in our knowledge database. We leverage this database to track and monitor trends and provide remittance advice. We also take proactive actions to eliminate the problems and maximize collections. </li></ul></ul><ul><li>Kaizen (Continuous Improvement) Sessions </li></ul><ul><ul><li>In order to continually improve, a monthly brainstorming session is conducted with clients. Methodology group captures ideas, issues, suggestions from the meeting and improve the existing processes. Trend analysis, recent changes, newsletters etc are also shared with the team. </li></ul></ul>
  21. 21. Security & HIPAA Compliance <ul><li>Talisman Solutions takes painstaking measures to protect all information related to patients. Our internal procedures for privacy and security meet and exceed all HIPAA regulations related to Electronic Transmission of Patient Information. </li></ul><ul><li>Physical Security: </li></ul><ul><ul><li>Access to our facilities is controlled by key entry only. Only authorized staff that is fully aware and trained in the HIPAA Privacy requirements will be issued access </li></ul></ul><ul><li>Information Security: </li></ul><ul><ul><li>We use an ICSA certified firewall and filter on incoming ports allowing only secured FTP and management ports for administrative access into our system. Our network also performs Network Address Translation (NAT) and addresses cannot be routed without traversing the firewall. </li></ul></ul><ul><ul><li>When our FTP Server is accessed with SSL FTP Client and all files are encrypted while being sent across the internet. So, anyone intercepting any data while it is being transferred from our server to your computer could not interpret or decode this data. </li></ul></ul><ul><ul><li>To access any data from our FTP Server, a valid user name and password is required. </li></ul></ul><ul><ul><li>Secured email is used for communication </li></ul></ul><ul><ul><li>Access to our network is limited by auto-log off, ID/password protection, password protected screen savers, and a security-enabled OS (WinNT) </li></ul></ul><ul><ul><li>We are not responsible for the security of files (documents or sound files) that are transferred to or from our server. </li></ul></ul>
  22. 22. Coding Services <ul><li>TSI offers high quality coding services to Hospitals and Healthcare Providers. Our team is comprised of experienced Certified Professional Coders (CPCs) accredited by the American Academy of Professional Coders (AAPC). They have proficiency in the following code sets and usage guidelines; CPT-4, HCPCS, ICD-9-CM, CDT, LCD/NDC and CCI EDITS. </li></ul><ul><li>TSI ensures the quality of our coders by an effective auditing and monitoring mechanism. Our coders work in accordance with updated standards and methodologies laid down by CMS, Medicare contractors, AMA, medical societies, and federal organizations. </li></ul><ul><li>We conduct detailed procedural processes to assess quality at every stage. </li></ul><ul><li>We use the most up to date books and software like CPT-4, ICD-9, HCPCS, CCI edit to keep in touch with the constant changes in the coding world. </li></ul><ul><li>We have dedicated professionals who work under the AHIMA rules. </li></ul><ul><li>Our coding staff have received extensive training under coding experts in the U.S. Certified coders monitor their work regularly and external coding and compliance experts periodically audit the department. </li></ul>.
  23. 23. Coding process <ul><li>Talisman has well-established coding process that ensures accurate coding for clients. </li></ul><ul><li>Talisman accesses Patient documents / files / reports etc. </li></ul><ul><li>Certified coder verifies and validates the documents, split them into batches and review them for completeness, quality and readability. </li></ul><ul><li>Diagnosis, Procedure Codes and Modifiers are assigned as per client descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code). </li></ul><ul><li>Diligent quality control team audits the coded charge sheets and processes it further for charge entry and cash posting </li></ul>
  24. 24. Talisman Software Product Offerings
  25. 25. Product Offerings <ul><li>iHelix products provide an end-to-end solution </li></ul><ul><li>Central repository allows for integrated solution </li></ul><ul><li>Better data and information integrity </li></ul><ul><li>Higher user productivity </li></ul><ul><li>Effective security, governance & compliance </li></ul>
  26. 26. Product Highlights <ul><li>Flexible subscription models </li></ul><ul><ul><li>Software-as-a-Service model </li></ul></ul><ul><ul><li>Licensed model </li></ul></ul><ul><li>Support for standards </li></ul><ul><ul><li>HL-7, DICOM, HIPAA, CPT, ICD9 </li></ul></ul><ul><li>Anywhere Access - Web based </li></ul><ul><li>Highly Configurable Solution </li></ul><ul><li>Multi-language support </li></ul><ul><li>Analytics/Management Reports e.g. key risk indicators </li></ul><ul><li>Rules & Workflow Engines </li></ul><ul><li>Security </li></ul><ul><ul><li>Integrated Compliance / Audit / Security </li></ul></ul><ul><ul><li>OTP(One time password ); Role Based / Account level security </li></ul></ul><ul><li>Real time reporting. </li></ul><ul><li>Built bottom-up with Latest technologies. </li></ul>
  27. 27. Popular features <ul><li>Change Log at system/terminal level </li></ul><ul><li>Resource assignment </li></ul><ul><li>Discharge Summary </li></ul><ul><li>Insurance Claims </li></ul><ul><li>Tariff Rules </li></ul><ul><li>Change Tariff </li></ul><ul><li>Picture upload for specific specialty </li></ul><ul><li>Image editor </li></ul><ul><li>Treatment Plans </li></ul><ul><li>Lab Templates </li></ul><ul><li>Package Rule/Package Assignment to the patient </li></ul><ul><li>Referral doctors accessing the medical records </li></ul><ul><li>Medical Certification Issues </li></ul><ul><li>Offline Processing </li></ul><ul><li>Lab Integration with equipment </li></ul><ul><li>Bio-Metric Integration </li></ul><ul><li>Medical record identification for facility </li></ul><ul><li>Ward Management </li></ul><ul><li>Procurement </li></ul><ul><li>OPD Services </li></ul><ul><li>Converting a patient from OP to IP </li></ul><ul><li>Discharge Summary </li></ul><ul><li>Drug Indents </li></ul><ul><li>Medical record based on Date selection </li></ul><ul><li>Off-load Analysis/Mobile clinics </li></ul><ul><li>SMS integration </li></ul><ul><li>e-mail integration </li></ul><ul><li>Bar Code/RFID Integration </li></ul><ul><li>Mobile Devices support </li></ul><ul><li>Text Editor ( Consent Forms) </li></ul><ul><li>Back up/Archiving </li></ul><ul><li>Alerts for prescription/drug reactions etc. </li></ul>
  28. 28. Q & A <ul><li>For Questions: </li></ul><ul><ul><li>(888)-617-9894 (Call); (866)-580-9174 (Fax) </li></ul></ul><ul><ul><li>[email_address] </li></ul></ul><ul><ul><li> </li></ul></ul><ul><ul><li>2000 Town Center, Ste 1900, Southfield, MI 48075 </li></ul></ul>