Trans-quest offers revenue cycle management and medical transcription services. They provide integrated healthcare revenue cycle management including medical transcription, coding, billing, denial management, and accounts receivable follow up for medical practices and hospitals. Their team includes certified coders and experienced billing specialists. They aim to maximize practices' cash flow through accurate eligibility verification, coding, billing submission, and aggressive accounts receivable follow up to resolve denials.

1. Revenue Cycle Management & Medical
Transcription Services

2. T
Is your money being kept from you?Is your money being kept from you?
We are professionals trained to overcome the
hurdles and tactics being used by GIANT insurance companies
and HMOs
We will work to reclaim what’s rightfully yours!We will work to reclaim what’s rightfully yours!

3. ABOUT USABOUT US
 Trans-quest is a HIPAA Compliant, Knowledge centric organization,
offering integrated Healthcare Revenue Cycle Management
services.
 We provide ‘Accelerators’ to overcome process and resource
limitations within your Revenue Cycle Management.
 Our services encompass Medical Transcription, Medical Coding,
Medical Billing, Denial Management and Accounts Receivables
follow-up for Physician groups, Individual Practitioners and
Hospitals
 Trans-quest has accumulated experience in handling virtually any
specialties and consciously provides cost containment, excellent
skills and cutting edge technology.

4. PROFESSIONAL TEAMPROFESSIONAL TEAM
Our people are our greatest assets. They are the very core of our customer-
oriented culture that allows us to guarantee service levels unmatched in the
industry.
 Professional Procedural Coders certified by American Academy for
Professional Coders (AAPC)
 Billing Specialists with experience in handling diverse specialties.
 Experienced AR Analysts and Denial Management Specialists

5. INFRASTRUCTUREINFRASTRUCTURE
Infrastructure is the backbone of our operations. Our state-of-the-art
technology center comprises of:
 2 MBPS Internet leased line with assured 24/7 connectivity.
 Network Infrastructure and Disaster Recovery.
 Structured cabling for all workstations.
 Network and Server monitoring executed by professionals.
 Data back up with remote storage facility
 100 % power back-up using online UPS and Generator with 24/7
assurance.
 Secured FTP facility.

6. Insurance companies benefit at the physician’s expense
Trans-quest is your catalyst, cutting down receivables and accelerating
cash flow

7. SERVICE OFFERINGS
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

8. IMPORTANCE OF ELIGIBILITY VERIFICATIONIMPORTANCE OF ELIGIBILITY VERIFICATION
You cannot collect fees from an insurance
company for ineligible patients.
 We ensure that every patient has been
screened for Eligibility before their
appointment and before a claim is submitted to
the insurance company
 Ineligibility of just 5% of patients, i.e. 1.5
patients/day assuming 264 working days at an
average of $50 per encounter, the physician
loses $19,800 annually
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

9. PROPER CODING & PCAPROPER CODING & PCA
 Are your CPT, ICD, and HCPCS codes up to date and
valid?
 Proper coding equals proper reimbursement!
 Incorrect codes cause delayed or denied payments
 Errors impact your cash flow.
Procedure Code Analysis
Simply provide us with your Super Bill
 Listing all of your CPT Codes
 Listing all of your ICD Codes
 Listing all of your HCPCS codes
We will integrate your CPT, ICD and HCPCS codes
into our proprietary Procedure Code Analysis
software and ensure that you no longer lose money
due to wrong/invalid codes.
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

10. THE BOTTOM LINETHE BOTTOM LINE
Minor Oversights Can Have a Major Impact:
Invalid Codes 10
Frequency of Use Once a Week
Average Charge $50 per Code
Projected Cost $25,000 of lost revenue
in a 50-week year!

11. ACCURATE ENTRY AND SUBMISSIONACCURATE ENTRY AND SUBMISSION
 All our staff are trained internally and must have a
minimum of 2 year “specialized” medical billing
experience.
 Our 3-tier Quality Assurance process ensures industry-
leading accuracy
Level 1: QC check by specialized QC team
Level 2: Validation Check by software
Level 3: Validation Check by Clearinghouse
software
 We adhere to strict workflow management
processes, that make sure there is absolutely no drop
in quality standards
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

12. ACCURATE ELECTRONIC CLAIMSACCURATE ELECTRONIC CLAIMS
TRANSMISSIONTRANSMISSION
 Our target is to electronically transmit all claims within 12
hours from the time the Charge Sheets (Superbills) and
correct patient documents are received by our office.
 We receive a specialized acknowledgement report after
transmission for immediate follow-up
One of the most common denial reasons given by insurance
companies is that the claim is not in the system. We dispute
the denial instantly since we maintain the proof of
transmission for each claim.
 Two types of reports generated after transmission
A) L1 Report – Generated 30 minutes after transmission, which
does a validation check before forwarding to the insurance
company.
B) L2 Report – Generated 24 hours after transmission, which
serves as an acknowledgement that the claims have reached
the insurance company.
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

13. INDUSTRY BEST PRACTICE BENCHMARKINDUSTRY BEST PRACTICE BENCHMARK
 The total accounts receivable in the 0-30 day
aging category should not exceed 70 percent of
monthly charges.
 The A/R in the 31-60 day category should not
exceed 15 percent of monthly charges.
 The A/R in the 61-90 day category should not
exceed 10 percent of monthly charges.
 The A/R in the 91-120 day category should not
exceed 7 percent of charges.
Eligibility
Patient’s coverage is verified
prior to visit
Coding
Medical Records are reviewed
and coded by Certified Coders
Demographic & Charge Entry
Billing specialists enter patient
demographics and charges into
the PMS
Transmission and Posting
Claims are sent to the
clearinghouse and payments
(EOB) received are applied to the
PMS
Accounts Receivable
Increase in collection ratio
through accurate analysis and
timely follow up
Revenue Recovery
Old AR are analyzed and
corrective measures are taken
(Resubmission)

14. DENIAL MANAGEMENTDENIAL MANAGEMENT
 Denied claims are worked on, rectified and resubmitted within 24
Hours on receipt of EOB.
 All Denials which require additional documentation, are sent to the
Doctor’s office on the same day that the EOB is posted.
 We specialize in working your old Account Receivables and we are
well versed with using correct appeal procedures in conjunction with
Healthcare Laws.

15. DENIAL MANAGEMENTDENIAL MANAGEMENT
 At Trans-quest Denial Management is handled by:
 Identification of key denial reasons.
 Identification of non-contractual adjustments due to denials.
 Identification of Problematic Payers.
 Identification of contractual issues.
 Qualification of denial reasons.
 Understand the financial impact.
 Trans-quest optimizes Denial Management by:
 Providing Good Documentation.
 Using accurate Procedure codes and modifiers.
 Utilizing well-informed, trained and qualified staff.

16. DENIAL MANAGEMENTDENIAL MANAGEMENT
 How do Trans-quest services help?
 By entering correct and accurate details in the PMS.
 Removing inconsistencies in the system that lead to denials.
 Following up on claims until paid.
 By using a tracking system, Trans-quest identifies
 Type of Denial.
 Reason for Denial.
 Resolution of the Denial.
 Corrective and Preventive action to eliminate denials in the future.
 Benefits Of Denial Management:
 Improved and accelerated cash flow.
 Reduction in write offs.

17. AGGRESSIVE FOLLOW-UPAGGRESSIVE FOLLOW-UP
 Our A/R and Denial Management Specialists receive extensive training
in AR follow-up.
 Aggressive follow-up starts 21 days after claim submission.
 Our Specialists are chosen for their analytical skills and are provided
with access to all the documentation required to make sure that the
claim is paid on the first call.
E.g. When the Insurance rep says that the claim is “Not in
system”, our Specialists are taught to immediately retrieve the
clearinghouse confirmation from our database and fax it while still
on the call.

18. SUMMARY OF SERVICESSUMMARY OF SERVICES
 Insurance and Eligibility Verification.
 Patient Demographics, Coding and Charge entry.
 Payment Posting and Reconciliation.
 Electronic and Paper Claim Filing.
 Secondary Carrier billing.
 Denial/Rejection Analysis.
 Insurance follow-up and Appeals.
 Practice Process Analysis and Continuous Improvement.
Additional Billable Services
 Patient Statements, Collection Notices, Reminder Calls
 Correspondence, Credentialing and Re-Credentialing.
 HIPAA Compliance and Consulting.

19. Trans-quest’s Advantages vs In-house Billing
• Corporate Approach
– Specialization, individual accountability, and emphasis
on reporting and metrics
• Flexibility and Scalability
– Predictable cost component regardless of growth or
seasonality
• Professional Qualifications
– Heavy concentration of certified coders, trained in an
environment that crafts expertise with Trans-quest
Office
• Total Focus, No Distractions
– No site-level distractions due to compound duties
• ROI
– Our staff is cost-competitive with most existing billing
operations, and allows staff to be productive in patient
care and throughput

20. Trans-quest Advantages vs. Other Billing Companies
• Enhanced Analysis Based on Large-Sample Data (Benchmarking)
– Better idea of acceptable performance in different specialties
• Professional Metrics
– Trend tracking, Daily / Weekly/ Monthly Financial Reports,
Collection Reports
• More Manpower
– Our ratio of staff per account is well above industry standard, for
higher touch and redundancy as well as better specialization
• Separation of Labor
– No crossover in staff from one account to another. Primary
billers working your account are exclusive to your company. This
results in more familiarity, improved performance and better
HIPAA controls
• Application expertise

21. QUALITY MANAGEMENTQUALITY MANAGEMENT
The Quality Management System
Processes based on ISO best practices for all
the elements, across entire lifecycle of an
outsourcing engagement.
Build the security infrastructure in line with
ISO Standards.
Define Business Continuity Management
Systems. (BCM)
Knowledge
Management
Process
Leadership
Quality
Management
System
Technology People
Operations/
Delivery

22. QUALITY ASSURANCEQUALITY ASSURANCE
 Experienced Quality Assurance team.
 Initial training for all process associates prior to job assignment.
 Monthly training based on continuously identified needs.
 Live monitoring of transactions for each process associate.
 Quality assessments of completed work based on random sampling.
 Redundant Screening through many processes
 Weekly quality review meetings to discuss quality concerns identified by
our Quality Audit department
All employees are required to take refresher courses in respective
departments
Monthly evaluations of all staff

23. VALUE PROPOSITION AND PRINCIPLESVALUE PROPOSITION AND PRINCIPLES
Allowing our customers to focus on Patient Care
Superior Service
ROI
Increased revenue
Reduced AR Days
Lower Bad Debt Write-offs
Reduced operational cost
On-time Delivery
Faster turnaround time
Accuracy
Process Compliance
Information Security Compliance
Trend Analysis for Continuous Improvement

24. HIPAA – PHYSICAL SECURITY STANDARDS
HIPAA AT Trans-quest
Facility Access Controls Centralized keycard access control across the entire
billing facility.
Facility Security Plan Locked doors, posted notice of restricted areas, Private
security service for the facility.
Access Control and
Validation process
Common practice is to question a person’s identity by
asking for proof of identity, such as a picture ID, before
allowing access to a facility.
Maintenance of Records Maintain a logbook that notes the date, reason for
repair and the person who authorized it.
Workstation Use and
Security
Account creation through the network resources.
Modifies and suspends user privileges through web
interface.
Data Back-up and
Storage
Maintain retrievable exact copies of PHI. Protect the
security of PHI while operating in an emergency mode.

25. HIPAA – TECHNICAL SECURITY STANDARDSHIPAA – TECHNICAL SECURITY STANDARDS
HIPAA AT Trans-quest
Access Control Unique user identification, Emergency Access procedure,
Automatic Logoff, Encryption and Decryption.
Audit Control Audit takes place once every 3 months, on the hardware,
software and procedural mechanisms which record and examine
activity in information systems that contain PHI.
Integrity We implement policies and procedures to protect PHI from
alteration and destruction. We ensure that the access to PHI by a
workforce member is appropriate.
Transmission Security Encrypted data transmission and password-protected electronic
fax lines

26. 509-214-1012 e-mail: sales@trans-quest.com
xxx-xxx-xxxx url: www.trans-quest.com
Contact Us