The document discusses Sun Knowledge, a medical billing and collections company. It provides an overview of Sun Knowledge's services, which include revenue cycle management, medical billing, coding and collections for providers, payers, and other healthcare organizations. It also outlines Sun Knowledge's infrastructure, certifications, and approach to addressing challenges in areas like eligibility verification, authorization tracking, and rejection management.
Step by Step Account Receivable Management Services for Hospitals by Sun Know...Michael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions and Step by Step Account Receivable Management Services for Hospitals
Sun Knowledge is your next-gen partner for expert solutions in AR services. Our quality processes and dedicated resources have been delivering state-of-the-art solutions in claims adjudication to major health insurance payers & providers.
We provide our tailored solutions for AR services for hospitals and helping them gain more reimbursements with reduced TAT. Over the years, we have developed our specialization with an astute understanding of Payer processes helping you set the tone with better collections.
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Accounts Receivable Management for Hospitals | Accounts Receivable ServicesMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
Account Receivable Services - http://sunknowledge.com/services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge is your next-gen partner for expert solutions in Accounts Receivable Management for Hospitals. Our quality processes and dedicated resources have been delivering state-of-the-art solutions in claims adjudication to major health insurance payers & providers.
We provide our tailored solutions for Accounts Receivable Management for Hospitals helping them gain more reimbursements with reduced TAT. Over the years, we have developed our specialization with an astute understanding of Payer processes helping you set the tone with better collections.
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Step by Step Account Receivable Management Services for Hospitals by Sun Know...Michael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions and Step by Step Account Receivable Management Services for Hospitals
Sun Knowledge is your next-gen partner for expert solutions in AR services. Our quality processes and dedicated resources have been delivering state-of-the-art solutions in claims adjudication to major health insurance payers & providers.
We provide our tailored solutions for AR services for hospitals and helping them gain more reimbursements with reduced TAT. Over the years, we have developed our specialization with an astute understanding of Payer processes helping you set the tone with better collections.
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Accounts Receivable Management for Hospitals | Accounts Receivable ServicesMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
Account Receivable Services - http://sunknowledge.com/services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge is your next-gen partner for expert solutions in Accounts Receivable Management for Hospitals. Our quality processes and dedicated resources have been delivering state-of-the-art solutions in claims adjudication to major health insurance payers & providers.
We provide our tailored solutions for Accounts Receivable Management for Hospitals helping them gain more reimbursements with reduced TAT. Over the years, we have developed our specialization with an astute understanding of Payer processes helping you set the tone with better collections.
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Welcome to Sun Knowledge for cost-effective solutions in healthcare outsourcing, including medical coding & billing, revenue cycle management, account receivables management and more.
HIPAA-Compliant Answering Services are Available 24/7Michael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Complete Durable Medical Equipment (DME) Billing Guide | Sun KnowledgeMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions in Durable Medical Equipment (DME) Billing & Collections.
Sun Knowledge has a highly capable team of DME billing experts who can make life easier for you from the very first day. With Sun Knowledge by your side, you can leave all your DME billing worries to expert care. Outsourcing your DME billing requirements to us will allow you and your staff to concentrate on marketing, growing and running business operations, rather than managing a billing and collections department.
The Sun Knowledge Advantage:
The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.
Highlights
~ Follow-up on incomplete prescription with physician’s office
~ Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
~ Error free patient entry
~ Error free sales order creation
~ 100% HIPAA compliance
~ Real time transaction audits
~ Primary and secondary insurance verification
~ Insurance verification for rental items
~ Obtaining authorizations & extending authorization
~ Open order audit and clean-up
~ CPAP user compliance tracking and counseling calls to non-compliant patients
~ Claims submission within 48 hours of receiving proof of delivery
~ Rejection follow-up within 24 hours
~ Tracking and follow-up of partial or incorrect payments
~ Denial management based on detailed analysis
~ Methodical and proactive AR follow-up
~ Timely payment posting to reflect accurate AR
~ Customized reporting
Get started today.
The Most Wonderful Time of the Year for Health-IT...NOTCompliancy Group
The Compliancy Group offers FREE HIPAA education with industry experts from across the industry. This months webinar with Axis Technology focuses on Health IT and the challenges that come with it. Register for our upcoming webinars at www.compliancy-group.com/webinar
Where does all the fruit waste go? How are those fruit peels, pulp, seeds and stones utilized ? How can we potentially use the fruit wastes to manufacture value added products for example by apple pomace. This presentation will do a fine job of answering all your queries!
Here is a quick, broad-strokes sell of Athens as an "Indie Mecca". It's formatted to define the term "Indie" in a broader sense of DIY ethic across industries, demonstrate that it is an old trend that continues to grow nationally, then spotlight Athens as a town which embraces indie efforts. Credit to the inimitable Aaron Draplin (draplin.com) for the beautiful state posters. Special thanks to the photographers of unsplash.com for large background images.
Welcome to Sun Knowledge for cost-effective solutions in healthcare outsourcing, including medical coding & billing, revenue cycle management, account receivables management and more.
HIPAA-Compliant Answering Services are Available 24/7Michael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Complete Durable Medical Equipment (DME) Billing Guide | Sun KnowledgeMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions in Durable Medical Equipment (DME) Billing & Collections.
Sun Knowledge has a highly capable team of DME billing experts who can make life easier for you from the very first day. With Sun Knowledge by your side, you can leave all your DME billing worries to expert care. Outsourcing your DME billing requirements to us will allow you and your staff to concentrate on marketing, growing and running business operations, rather than managing a billing and collections department.
The Sun Knowledge Advantage:
The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.
Highlights
~ Follow-up on incomplete prescription with physician’s office
~ Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
~ Error free patient entry
~ Error free sales order creation
~ 100% HIPAA compliance
~ Real time transaction audits
~ Primary and secondary insurance verification
~ Insurance verification for rental items
~ Obtaining authorizations & extending authorization
~ Open order audit and clean-up
~ CPAP user compliance tracking and counseling calls to non-compliant patients
~ Claims submission within 48 hours of receiving proof of delivery
~ Rejection follow-up within 24 hours
~ Tracking and follow-up of partial or incorrect payments
~ Denial management based on detailed analysis
~ Methodical and proactive AR follow-up
~ Timely payment posting to reflect accurate AR
~ Customized reporting
Get started today.
The Most Wonderful Time of the Year for Health-IT...NOTCompliancy Group
The Compliancy Group offers FREE HIPAA education with industry experts from across the industry. This months webinar with Axis Technology focuses on Health IT and the challenges that come with it. Register for our upcoming webinars at www.compliancy-group.com/webinar
Where does all the fruit waste go? How are those fruit peels, pulp, seeds and stones utilized ? How can we potentially use the fruit wastes to manufacture value added products for example by apple pomace. This presentation will do a fine job of answering all your queries!
Here is a quick, broad-strokes sell of Athens as an "Indie Mecca". It's formatted to define the term "Indie" in a broader sense of DIY ethic across industries, demonstrate that it is an old trend that continues to grow nationally, then spotlight Athens as a town which embraces indie efforts. Credit to the inimitable Aaron Draplin (draplin.com) for the beautiful state posters. Special thanks to the photographers of unsplash.com for large background images.
CREATIVITY: Renew Your Thinking, Transform Your LifeEfiong Etuk
A global mass creativity campaign. Setting right the way we think about ourselves and the purpose of our life, so that humankind may thrive and flourish into the infinite future.
Recovery: Job Growth and Education Requirements Through 2020CEW Georgetown
Recovery: Job Growth and Education Requirements Through 2020: Projections of jobs and education requirements through 2020. This report shows where the jobs will be by education level, occupation and industry. Recovery 2020 is an update to our Help Wanted: Projections of Jobs and Education Requirements Through 2018.
African Americans: College Majors and Earnings CEW Georgetown
While college access has increased among African Americans, they are overrepresented in majors that lead to low-paying jobs. In our new report, African Americans: College Majors and Earnings shows that African Americans are underrepresented in the number of college majors associated with the fastest growing, highest-paying occupations. Read the full report: http://bit.ly/20M28d1
How to run system administrator recruitment process? By creating platform based on open source parts in just 2 nights! I gave this talk in Poland / Kraków OWASP chapter meeting on 17th October 2013 at our local Google for Entrepreneurs site. It's focused on security and also shows how to create recruitment process in CTF / challenge way.
This story covers mostly security details of this whole platform. There's great chance, that I will give another talk about this system but this time focusing on technical details. Stay tuned ;)
Creative Traction Methodology - For Early Stage StartupsTommaso Di Bartolo
How to build a mindset that gets a new product traction? 99% of all startups are forced to give up because they lack traction. As founders are thrilled and captivated to build a product that could change the world - the majority downright neglects to put equal efforts towards how to differentiate in taking the product to market. The difference between those who make it to get traction and the rest lies in the innovator’s mindset.
Sun Knowledge - Practice Management and Revenue Cycle Management Services PPTMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
We provide our tailored solutions for any healthcare practices helping them gain more reimbursements with reduced TAT. Over the years, we have developed our specialization with an astute understanding of Payer processes helping you set the tone with better collections.
Our clients prefer us for:
~ Powerful references from major healthcare providers and health insurance payers
~ Instant reduction of billing costs by 70%
~ Managing high volume claims with robust processes
~ Collections of up to 97%
~ 99% medical billing & coding accuracy
Sun Knowledge is a revenue cycle management company and expert in various practice management software. We also provide services for following medical billings, medical coding, account receivable, denial managements, claims adjudications, claim processing, authorization and verification, insurance follow up, and many more.
We are specialize in Hospitals, urgent care centers, DME, orthotics, prosthetics, Nursing home, physician office and many more billing industry.
Revenue cycle management by sun knowledge (labs)Nibedita Sen
To make #Accounts Receivable and #RCM less complicated, it is mandatory to go through a transcendent process of #MedicalBilling to improve sinking finances.
Step by Step Anesthesiology Billing, Coding, Revenue Cycle Management and Pra...Michael Smith
Sun Knowledge is a leading global provider of Business and Knowledge Process Outsourcing services in the health care domain. We deliver proprietary technologies, workflow and business processes to meet our client’s expectations and enhance their workflow and business processes to meet operational capabilities.
Join - https://www.linkedin.com/company/sun-knowledge
Google - https://plus.google.com/+SunknowledgeInc
Follow - https://twitter.com/sunknowledge
Like - https://www.facebook.com/SunKnowledge
Website - www.sunknowledge.com
Service - http://sunknowledge.com/services/
Provider Solutions - http://sunknowledge.com/services/provider-solutions/
Payor Solutions - http://sunknowledge.com/services/payor-solutions/
Technology Solutions - http://sunknowledge.com/services/technology-solutions/
Contact - 41 Madison Avenue, 25th Floor, Suite 2511, NY - 10010
Phone - 646 - 661 - 7853
Email - ronnie.hastings@gotelecare.com
Telemedicine
Offered through our sister organization GoTelecare, the Telemedicine application ushers in a new era of ease and convenience in remote health care delivery. We invite you to explore its amazing capabilities and understand how it can help you as a patient or a healthcare provider.
Medication Therapy Management Patient-Oriented Software
Our proprietary Medication Therapy Management (MTM) web application is the definitive answer to resolving all your medication-related issues in the most comprehensive and cost-effective manner. Get ready to experience a whole new way to automate tasks, reduce errors, cut costs and boost productivity.
Software Development
We offer valuable guidance to our service-users on how to systematize, maintain and manage their software assets, consistently and faultlessly, throughout their life-cycle. Our competent IT professionals provide clients with an exhaustive range of solutions, allowing maximum cost-containment and addressing their business challenges effectively.
Our broad spectrum of software services includes:
~ Business Analysis and System Design
~ Technology Architecture Consulting
~ Application Software Development
~ Maintenance and Technical Support
~ Production Support
~ Troubleshooting and Issue Resolving
~ Managing Updates and Patches, and more!
This is where we can make a big difference. Our proactive and streamlined revenue cycle management process gives you complete visibility and assurance of your payments – starting from charge entry to claims submission through payment follow-up.
We have been successfully serving healthcare providers in every domain – physicians, hospitals, urgent cares and durable medical equipment. Our billers and coders are proficient in working in several industry-standard practice management and billing systems, and have an excellent track record in delighting each customer through their expertise, dedication and steady focus on making you realize your payments on time.
Accounts Receivable Management for Nursing Homes by SunKnowledgeMichael Smith
Our Accounts Receivable follow-up process monitors and proactively pursues collection of payments. All claims that have not been closed out in the system are categorized by age and insurance for effective management of the follow-up process. Calls are initiated for claims that are 31 days old or more. We attempt to identify the source of the problem through proactive calling so that the turn-around time on collections can be reduced.
Diligent follow-up for paper submissions ensures that “claims not on file” are resubmitted within filing limits. Weekly A/R Reports are analyzed and reviewed to prioritize work for the week. All interactions with payors are documented in detail, making repeat follow-ups streamlined and more effective. Our experienced team is adept at gathering information through appropriate probing questions. Findings are communicated with clients through a detailed report on a daily basis. The report also includes suggestions for actions to be taken from the client’s end e.g. resubmitting with medical notes, or with modifier/coding changes, and so on.
At Sun Knowledge, every cash amount receives the same degree of attention as the other, irrespective of its size or source. Combine that with our high accuracy standards and you can rest assured that every penny you are entitled to will be claimed and recovered by us in the shortest possible time! Moreover, our knowledge of pertinent federal laws and acts such as EMTALA (Emergency Medical Treatment and Labor Act), ERISA (Employee Retirement Income Security Act), the Prompt Pay Law and others, help in resolving issues and settling accounts much faster than other A/R Managing companies.
Highlights
~ Streamlined and improved workflow using effective tracking tools
~ Multiple follow-up calls for the same claim
~ Follow-up on all paper submissions
~ Payor-specific analysis
~ Detailed reporting with suggestions for actions to be taken
~ Improved cash flow
~ Reduction in turn-around time
~ 100% HIPAA compliant~
~ Collections up-to 97%.
~ We charge only $8 per hour per dedicated FTE (Full Time Employee).
~ Our charges are only $5 per prior authorization. Lowest in the industry.
~ Excellent references.
~ Free Telemedicine Platform.
~ We also provide check posting services.
We also buy accounts receivable that have been difficult to recover and will pay you up to 85% of the total claim value. We even purchase accounts receivable older than 180 days that nobody else would touch! Click here to sell your unpaid invoices for instant cash.
1. MEDICAL BILLING
& COLLECTION
FOR DME
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
2. Private & Confidential 2Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
SUN KNOWLEDGE OVERVIEW
Key Facts Awards, Affiliations & Certifications
‘Onshore /Offshore’ KPO & BPO Services
Serving US healthcare industry since 2007
Robust & scalable infrastructure
State-of-the-art technology and systems
Highly skilled and trained staff with good
communication skills and in-depth knowledge of process
Structured training, feedback and coaching
HIPAA-HITECH compliant
State-of-the-art office inbuilt with all redundancies –
power, infrastructure and others
ISO 27001:2013 and ISO 9001:2008 certified
CMMi-SVC implementation in progress under KPMG
guidance
Member of NASSCOM, the Governing Industry body for
IT/ITES in India
Awarded ‘Best Emerging BPO Company of the year 2010’
by The Economic Times, India
Recognized as one of the foremost 'Emerging companies in
Eastern India' by NASSCOM in 2011
Awarded Asia-wide “Healthcare BPO Provider of the Year”
at the Asia BPO Excellence Awards ceremony hosted by
Asia BPO Summit on 14th February 2013 in Mumbai, India
Awarded the prestigious “Outsourcing Service Provider of
the Year” award in the Asian Outsourcing Excellence
Awards ceremony hosted by CMO Asia on 1st August 2013
in Singapore
Awarded “Highest New Job Creator (IT/ITES)” by STPI
(Software Technology Parks of India) on 3rd December 2015
Office at
41 Madison Avenue, 25th Floor,
New York, NY 10010
3. SUN KNOWLEDGE SERVICE PORTFOLIO
Provider Support
Member Support
Member Retention Program
Clinical Help Desk
Contact Center
Utilization Management
Medication Therapy Management
Hospital Re-admission Management
Therapeutic Interchange
Formulary Management
Clinical Services
Medical Coding & Billing
Claims Administration
Enrollment Processing & Member
Fulfillment
Credentialing
Premium billing and collections
Administrative Services
Analytics
Telemedicine Services
Remote Patient Monitoring
Application Development & Support
Technical Support
Technical Documentation
IT Services
Claims /Drug Utilization
Analysis
PDE Analysis
RAF Analysis
Payment Reconciliation
We provide services to
Providers – Physicians, Hospitals, DME, P&O, Home Health Care and Pharmacies
Payers – Commercial Plans, MA Plans, Medicaid HMOs, MAPD/PDPs, IPAs, MSOs, TPAs, PBMs and RBMs
Private & Confidential 3Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
4. SUMMARY OF SERVICES
PRACTICE
MANAGEMENT
Scheduling
Eligibility &
Authorization
Verification
Prior Authorization
Customer Care
BILLING &
COLLECTIONS
Coding
Charge Posting
Claims Submission
Payment Posting
Denial Management
Accounts Receivable
PAYER SERVICES
Claims
Adjudication
Credentialing
Utilization
Management
Customer Care
TELEMEDICINE
Telemedicine
Remote Patient
Monitoring
Private & Confidential 4Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
5. HIPAA COMPLIANCE SUMMARY
SL. COMPLIANCE ASPECT HIGHLIGHTS
1 Physical Access Authorized access only | Bio-metric access | Proximity card system | Photo ID cards | Access log review
2 General Security 24 hour security personnel | Logging of visitor details | Physical register retained for 10 years
3 Monitoring CCTV monitoring (with recording) of production area | Daily review of recording
4 Vendor Access
Signing confidentiality agreement before accessing sensitive areas | Accompanied by security personnel/employee during
all times
5 Mobile Phones All employees (except managers) are required to deposit mobile phones in the locker box before entering facility
6 Personal Baggage No backpacks or other bags allowed | All baggage to be deposited in locker box before entering facility
7
Network &
Application Usage
Unique user IDs created using Microsoft Active Directory | Access to storage devices, shared drives, USB/mass
storage devices, printers – controlled by Domain Group Policy | No wireless access points
8 Firewall
Unified Threat Management System | Internet traffic regulation using multiple filters | Network Address Translation (NAT) |
Intrusion Prevention Systems (IPS) | Port-mapping for traffic between Virtual LANs | Default setting to deny all traffic
9
VPN (Virtual
Private Network)
Site-to-site IPSec VPN tunnels | Authorized access via client-to-site VPN connections | Access authorization
controlled by Active Directory's authentication service
10
Redundancy
Management
Fully redundant network stack | Two ISP links configured in active-active mode | Power backup supplied by 130 KVA UPS
and 750 KVA generator | 22 KVA UPS backup for server and network systems
11
Virus & Malware
Protection
Central anti-malware system | Automatic updates | Extra protection by gateway firewall |
Centralized OS patch management system (using Microsoft's WSUS server)
12 Other Measures Fire extinguishers at key areas | Half-yearly fire drills
Private & Confidential 5Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
6. REVENUE CYCLE
MANAGEMENT
Private & Confidential 6Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
7. REVENUE CYCLE MANAGEMENT – KEY PROCESSES
360°
Revenue Cycle
Management
Services
Eligibility &
Authorization
Verification
Patient
Information
Entry
Coding
Charge Entry
Claim
Submission
Payment
Posting
Accounts
Receivable
Denial
Management
Reporting
Private & Confidential 7Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
8. SERVICE HIGHLIGHTS
Up to 97% collection rate in accounts receivable
FREE medical billing software, EMR & setup
Real-time eligibility checks & fast authorization
100% HIPAA-HITECH compliance
Rapid claim status analysis in denial management
Turnaround time less than 48 hours max.
Low service fees with no hidden cost
Zero lockup service contract that can be cancelled anytime
Excellent references from reputed clients across the US
Real-time audits and custom reporting
Private & Confidential 8Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
9. REVENUE CYCLE MANAGEMENT
• Physicians / Hospitals
• DMEPOS
• Pharmacy (WC/ PIP)
Work with physicians to enroll them with payers, setup billing
systems with fee schedules, review clinical notes, code CPT/ICD,
submit claims, payment posting and follow-up with payers and
patients
Setup DME companies in DME billing system, receive orders, generate
claims, payment posting and follow-up with payers and patients
Setup billing systems for submission of WC/PIP claims, code and
apply correct modifiers, check eligibility with adjusters, generate
claims, payment posting and follow-up
Sun Knowledge provides medical billing & coding services - prompt, perfect and professional.
We are HIPAA compliant.
Private & Confidential 9Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
10. REVENUE CYCLE MANAGEMENT SERVICES
End-to-End Billing Services:
Hospitals/ Physicians
DMEPOS
Pharmacy (WC/PIP)
Stand Alone Billing Services:
AR Follow-up & Collection
Eligibility & Auth Verification
Pre-Auth Service
Credentialing
Patient Collection
Coding
Private & Confidential 10Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
11. PRACTICE MANAGEMENT & BILLING SYSTEM
Sun Knowledge billing executives have experience in working on several industry
standard practice management and billing software:
Sun Knowledge can provide medical billing & coding services
using customer’s billing system or can setup customer’s practice
in a billing system managed by Sun Knowledge.
Kareo SOS
Emdeon / Capario One Meditech
Brightree Alpha Collector
Fastrack OPIE
CPR+ HME Futura
DME Works PrimeRx
Team DME
Private & Confidential 11Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
12. CHALLENGES & OUR APPROACH
Assignment of adequate staff
Completion of secondary verification
Rigorous audit
Time consuming with limited staff
Documentation collection requires
continuous follow-up
Increased TAT
Time consuming with limited staff
Secondary verification not carried out
Checking Authorization
Requirement and
Obtaining Authorization
Eligibility Verification
Patient Demographics /
Insurance / Charge Entry
Transaction audit to minimize errors;
reduces denial due to missing patient
information
TASK DESCRIPTION CHALLENGES APPROACH
Missing information / Key-in errors
Increased denial rate
Increased TAT
Assignment of adequate staff
Systematic and regular follow-up with
physicians’ offices & payors to collect
documentation and obtain authorization
Proper tracking mechanism
Private & Confidential 12Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
13. CHALLENGES & OUR APPROACH
Defining KPI for rejection management
process and assigning responsibility
Claims reconciliation and exception
report generation
Unapplied balance
Accumulation of backlog
Manual posting
Denials not posted
Delayed correction and resubmission
Possible loss of payment
Payment Posting
Rejection Management
Paper Claim Submission
Proper tracking of every submission of
paper claims
Moving to EDI based submission
whenever possible will reduce cost of
manual work and faster payment cycle
TASK DESCRIPTION CHALLENGES APPROACH
Additional work for printing and
faxing/mailing
Delayed filing leading to denials
Lack of information about the actual
status
Defining guidelines
Review of patient payments
Define KPI – TAT & Accuracy
Denial posting and review
Private & Confidential 13Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
14. CHALLENGES & OUR APPROACH
Proper documentation – process
manual, guidelines & checklists
Defining proper tracking mechanism
through various reports -Ageing, Status,
Daily, Exception
Generate exception reports and regular
audit of every process tasks
Defining KPIs and assigning
responsibility
Lack of clarity of claims volume and
current status affects management
decision making process
Impact on overall billing process
performance and improvement
Decreased productive efficiency
Process Administration
and Reporting
AR Follow-up &
Denial Management
Regular analysis, follow-up and review
Transaction audit
TASK DESCRIPTION CHALLENGES APPROACH
Accumulation of backlog
Denials not posted
Claims reconciliation issue
Private & Confidential 14Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
15. ADDRESSING PROBLEMS WITH EFFECTIVE SOLUTIONS
We address problems like:
Reduced profit margins
Caused by
• Claims denial
• Delayed submission of claims
• Inefficient processes
• Low productivity
Reduced strategic directives
Caused by
• Operation reports lacking focus on
orders received/delivered
• Reports on claims submission
lacking functional clarity
We produce benefits like:
Process optimization
Achieved through
No backlogs in inventory/open order
Significant reduction in payment realization cycle
Reduction in average cost by 40%
Improved efficiency leading to higher productivity
Improved financials
Achieved through
Timely claims submission, leading to improved
cash flow and payment realization by 10%
Significant reduction in denial rate
Increased revenue by 7%
Private & Confidential 15Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
16. FACTS FROM A CASE STUDY
Sun Knowledge recently helped a leading DME Provider in New York
improve their complex billing process and achieve long-term bottom-line
growth. Here’s how we added value to the client’s existing processes:
OLD BILLING
PROCESS
OPTIMIZED BILLING
PROCESS
PROCESS STABILITY: Achieved
consistent and better productivity; and
higher accuracy through the application
of an improvement methodology
QUALITY AND EFFICIENCY IMPROVEMENT: Developed clear
understanding of peculiarities of DME billing as compared to physician
billing; Initiated an internal audit mechanism to identify and rectify
errors; Enforced corrective and preventive action scheme
INCREASED PRODUCTIVITY AND REDUCED
OPEN ORDERS: Removed redundant process
steps to focus on the critical ones; Created tools /
cheat sheets and introduced various process
checks to improve productivity
REDUCED DENIAL RATES: Drastically
reduced incorrect coding and combination in
bills and developed a thorough understanding
of qualifying diagnosis and payer guidelines
Private & Confidential 16Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
17. DME BILLING SERVICES
Private & Confidential 17Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
18. DME BILLING – KEY FACTS
Secure Information & Data Flow between Sun knowledge and our partners enabled
with reliable networking software & hardware (includes secured Virtual Private
Networks and FTP sites)
All low pay and no pays reports are sent to the client
Work on re-processing of the denied claims starts immediately after receipt of ERA
ERAs are posted to the respective patients’ accounts
Quality check is conducted at all stages of process
Turn Around Time for this process is 24 - 48 hours
Private & Confidential 18Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
20. ELIGIBILITY & AUTH. VERIFICATION – SAMPLE REPORT
SUN KNOWLEDGE ELIGIBILITY VERIFICATION & AUTHORIZATION DETAILED FOR ABC - (7/10/2015)
Sl. No. Patient #
Equipment
Category
Eligibility
Checked
Primary
Checked
Secondary
Checked
Auth
Required
Auth
Obtained
Fax sent
Auth
Pending
Comment
1 221359 Beds / Mattress Yes Yes No Yes No Yes Yes
Pending Auth# Ak-098651
Follow-up : 07/15/2015
2 328547 Beds / Mattress Yes Yes No Yes No Yes Yes Follow-up : 07/14/2015
3 190398 CPAP - Machine Yes Yes No Yes No No Yes
Sleep study report missing. Dr.'s
office contacted
Follow-up : 07/13/2015
4 215604 Diabetic Supplies Yes Yes Yes No Yes Yes No Follow-up : 07/14/2015
5 218219 CPAP - Machine Yes Yes No Yes No Yes No Follow-up : 07/17/2015
EIGIBILITY VERIFICATION & AUTHORIZATION SUMMARY REPORT FOR ABC - 07/10/2015
Equipment
Category
Number of New
Patients
Patients Brought
Forward
Total
Patients
Primary
Checked
Secondary
Checked
Auth Required Auth Obtained Fax sent Auth Pending
Beds / Mattress 25 0 25 25 4 19 2 2 17
CPAP (Supplies) 44 3 47 47 12 9 7 6 2
CPAP (Machine) 15 0 15 15 3 11 3 3 8
Other DME 50 12 62 61 18 23 5 21 18
Diabetic
Supplies
27 0 27 27 6 8 6 8 2
Total 161 15 176 175 43 70 23 40 47
Private & Confidential 20Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
21. CPAP USER COMPLIANCE & TRACKING – SAMPLE REPORT
CPAP USER COMPLIANCE TRACKING SUMMARY REPORT FOR ABC - 07/10/2015
Day No. of Patients
Compliant Patients
No. of Non-
Compliant
Patients
No. of Patients
with No Data
Available
PendingNo. of Compliant
Patients
No. of Patients
Compliant based on
best 30 days
90th
day Compliance Report 5 3 0 0 0 2
60th
day Compliance Report 4 1 3 0 0 0
30th
day Compliance Report 7 3 0 2 1 1
15th
day Compliance Report 0 0 0 0 0 0
5th
day Compliance Report 1 1 0 0 0 0
TOTAL 17 11 2 1 3
SUN KNOWLEDGE CPAP USER COMPLIANCE TRACKING STATUS REPORT - 07/10/2015
S No.
Set Up
Date
5th Day
15th
Day
30th
Day
60th
Day
90th
Day
Patient # Patient Name Doctor System Status
Therapy
Report
Imaged
Report
Faxed to Dr.
Email
/Faxed
Sales
person
Payer Name
Comment /
Notes
1 4/8/2015 N/A N/A N/A N/A 83.45% 213765 DOE, JOHN Paez Encore Complete Yes Yes No OXFORD HEALTH PLANS
2 4/8/2015 N/A N/A N/A N/A 65.60% 218619 DOE, DAVID Smith Resmed Complete Yes Yes No OXFORD HEALTH PLANS
Best of 30 days-
73.3%
3 6/6/2015 N/A N/A 100% N/A N/A 125354 DAY, JULIE Ricardo Encore Complete Yes Yes No MEDICARE
4 6/5/2015 N/A N/A 96.70% N/A N/A 295695 ROE, JANE Paez Encore Complete Yes Yes No HEALTH FIRST NY
5 6/30/2015 80% N/A N/A N/A N/A 233432 DOE, JULIE Paez Encore Complete N/A N/A N/A HEALTH FIRST NY
6 5/27/2015 N/A N/A 100% N/A N/A 196476 SMITH, JOE Jones Resmed Complete Yes Yes No MEDICARE
7 5/23/2015 N/A N/A 73% N/A N/A 215604 BLOGGS, JOE Jones ICODE Complete Yes Yes No AETNA HEALTH PLAN
8 6/3/2015 N/A N/A 57% N/A N/A 217849 SMITH, JULIE Smith Resmed Complete Yes Yes No MEDICARE
9 6/27/2015 100% N/A N/A N/A N/A 168488 ROE, JOHN Jones ICODE Complete N/A N/A N/A MEDICARE
10 5/1/2015 N/A N/A N/A 67.00% N/A 214535 RODRIGUEZ, P Jones Encore Complete Yes Yes No HEALTH FIRST NY
Private & Confidential 21Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
22. AR & AR CALLING – SAMPLE REPORT
Payer
>120 Days 91 – 120 Days 61 – 90 Days 31 – 60 Days
Claims Completed Remaining Claims Completed Remaining Claims Completed Remaining Claims Completed Remaining
AARP HEALTH CARE OPTIONS 26 23 3 17 16 1 44 41 3 37 32 5
AMERICAN TRANSIT INSURANCE
COMPANY
12 11 1 6 5 1 15 15 0 10 10 0
BCBCS 28 24 4 16 13 3 41 37 4 32 30 2
MAGNACARE 13 12 1 9 9 0 23 22 1 11 10 1
HIP_PALLADIAN HEALTH 6 6 0 12 9 3 12 10 2 15 15 0
MANAGED PHYSICAL NETWORK 12 10 2 8 7 1 10 10 0 10 8 2
MAGNACARE 7 7 0 2 11 -9 5 5 0 8 3 5
OXFORD 12 9 3 17 12 5 23 22 1 22 16 6
STATE FARM INSURANCE 7 6 1 4 4 0 5 5 0 4 4 0
TOUCHSTONE HEALTH 5 5 0 8 6 2 6 4 2 16 12 4
UNITED HEALTHCARE 31 28 3 23 20 3 49 43 6 41 39 2
S
No.
Date Payer
Patient
Name
DOB DOS Claim No.
Charge
Amount
Status Comments Ref #
1 7/21/2015 Healthfirst Doe, John 8/29/1974 6/26/2015 1063051526 $195.00 Paid
Called Healthfirst spoke with Gary - Rep stated that claim received
on 06/30/15 and processed on 07/17/15. Per rep ins paid $173.47
on check# 3023659 having bulk amount $11909.23. Check was
issued on 07/17/15 and is not cashed yet.
1063051526
2 7/21/2015 Healthfirst Roe, Julie 5/3/1983 6/16/2015 1091527510 $195.00 Paid
Called Healthfirst spoke with Gary - Rep stated that claim received
on 06/19/15 and processed on 07/10/15. Per rep ins paid $173.47
on check# 3019387 having bulk amount $25091.99. Check was
issued on 07/10/15 and is not cashed yet.
1061915510
3 7/24/2015 Magna Care (Oscar) Roe, David 8/11/1942 5/26/2015 P0449302 $3,800.00 Paid
Per Ashley- rep stated that claim received on 06/05/15 and ins
applied $292.60 towards pt as coins and paid 2633.40 by ck#
69783. Check issued on 07/10/15 and not yet cashed.
CL725541
4 7/24/2015 Magna Care (Oscar) Bloggs, Joe 8/10/1952 6/17/2015 Q0487598 $252.11 In Process
Per Ashley - Rep stated that claim received on 07/06/15 and still
in process
CL8765541
5 7/29/2015
Health Republic
Insurance of New
York
Bokhari,
Shahid
3/4/1958 6/19/2015 16478355-01 $100.00 Allowed
Per Andriya stated that claim processed on 07/08/15 and ins
applied $82.89 towards in-network deductible, Per rep the annual
in-network deductible is $2000.
18441664
6 7/31/2015 Oxford Health Plan Smith, P 4/25/002 6/8/2015 5184T02894 $59.62 Paid
Per Kelly stated that claim paid $42.58 on ck# 13357299 having
bulk amount $221.32 issued on 07/28/15 and not cashed yet.
15298601
Private & Confidential 22Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
23. DENIAL MANAGEMENT – SAMPLE REPORT
Auth Related
14%
Coding Error
5%
OON Issue
8%
COB Issues
10%
Patient info
missing
6%
Exceeds
Timely Filing
8%
Duplicate Claim
5%
Service Not
Covered
6%
Primary Paid
Max
7%
Pre-Existing
Condition
5%
Others
26%
Distribution of Denied Claims
Private & Confidential 23Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
24. SOCIAL MEDIA MARKETING
Private & Confidential 24Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
25. EVEN MORE BENEFITS
Private & Confidential 25Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
ACTIVE BRANDING & VIGOROUS LEAD GENERATION THROUGH SOCIAL MEDIA MARKETING
3.4
Million
Healthcare
Providers
Tap into our massive, and ever-growing, database
of over 3 million healthcare providers from every
corner of the US, and discover your next client!
Active
Multi-
Channel
Marketing
Targeted, high quality lead generation through various
digital channels for B2B marketing such as Email
marketing, SEO (Search Engine Optimization), LinkedIn®
marketing, PPC (Pay Per Click) advertising, and more!
26. BENEFITS PROPOSITION
Increased revenue – reduced collection Time (up to 97% collection rate)
Claim submission within 48 hours of receipt of billing input
Adherence to CMS billing requirements
Proper records maintenance and visibility through reporting
Standardization of billing operations
Private & Confidential 26Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
27. CLIENTSPEAK
“I was always against the idea of outsourcing our back end claims processing
work but I was wrong. Sun Knowledge provided extraordinary deliverables
on a timely basis which led to cost cutting considerably for us.”
CEO of a leading MA-PD Plan
Private & Confidential 27Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
Ronnie Hastings
(646) 661-7853
Email: ronnie.hastings@sunknowledge.com
Sun Knowledge
41 Madison Avenue, 25th Floor,
New York, NY 10010
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