GoTelecare Medical Billing & Coding Services

GOTELECARE SERVICES
MEDICAL BILLING & CODING

2© GoTelecare 2015-16| All Rights Reserved Private & Confidential
 ‘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
 Offices located in US & India
• New York City, US – Situated in Manhattan (facility
inbuilt with all redundancies – power, infrastructure
and others)
• Kolkata, India – Situated in the IT Hub
(facility inbuilt with all redundancies – power,
infrastructure and others)
 Sun Knowledge, our contracted company, is ISO
27001:2005 and ISO 9001:2008 certified company.
 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
GoTelecare – Overview
Key Facts Awards, Affiliations & Certifications

MEDICAL BILLING &
CODING SERVICES

REVENUE CYCLE MANAGEMENT – OVERVIEW
Revenue Cycle
Management
Components
Billing
Coding
Account
Receivables
Eligibility
Verification &
Authorization
Scheduling
Payment
Posting

REVENUE CYCLE MANAGEMENT – SERVICE PORTFOLIO
Billing
 Patient entry demographics & insurance information
 Fee schedule / charge entry
 Scrubbing of all entries for correctness and completeness through appropriate billing edits; correction of identified errors
 Submission of claims to payers, e.g. EDI or paper
 Creation and mailing of patient statements
 Posting of payments received from patient and payer
 Reconciliation of charges, payments received and adjustments made
Denial Management and A/R Follow-up
 Denial Management, e.g. understanding denials and making corrections
 Resubmission of claims
 AR calls as follow-up on outstanding issues
 Closure of a claim once the balance is zero
Medical Coding
 Inpatient/Outpatient Hospital Coding
 Physician Coding

MEDICAL BILLING & CODING – HIGHLIGHTS
 Above 95% Collection Rate
 Claims Submission TAT 24 – 48 hours max.
 Error-free Patient Entry
 Over 99.9% Coding Accuracy
 Real Time Audits
 Proactive Follow-up on Rejections
 Denial Management
 Methodical and Proactive AR Follow-up
 100% HIPAA Compliance
 Custom Reporting

MEDICAL BILLING & CODING – HIGHLIGHTS
We provide Medical Billing Services in the following areas:
Urgent Care Inpatient Hospitalization DME (Durable Medical Equipment)
Pathology Critical Care Radiology
Pulmonary EKG Ambulatory Surgery Center
Cardiology ENT Orthopedic Surgery
Anesthesia Family Practice Internal Medicine
Rehab Center Pharmacy Physician Group, and more…

MEDICAL BILLING – CYCLE
Encounter
(SOAP)
notes
review
Superbill
generation
and code
review
Claims edit
checking
and
correction
EDI claims
submission
through
clearing
house
Rejection
management
ERA/EOB posting
and reconciliation
Automatic
secondary
payer billing
Denial
Management
AR
Follow-up

BILLING SYSTEM
We use Kareo for coding and billing services that covers the complete billing cycle:
 SOAP notes review
 Superbill generation and coding
 Claims edit checking and correction
 Claims submission through EDI clearing house at a scheduled time
 Rejection management
 ERA/EOB posting and reconciliation
 Automatic secondary payer billing
 Denial Management
 Patient statement generation and mailing

CLIENT BENEFITSMEDICAL BILLING - PAYMENT/DENIAL POSTING
Select Patient Account
Select EncounterSelect Encounter
If not found
Refer Client SpecifiesDenial
Denial Code
Hold Transfer BalanceTransfer BalanceWrite-off
Post Payment
Payment
Payment Entry Process-Flowchart
Payment posting is a crucial step in billing process, looking at the sensitivity of this process,
accurate and efficient payment posting process is indispensable for Physicians office.
Our billers are known to be highly efficient and analytical in payment posting process.
The flow chart below illustrates the Payment Entry process followed.

Go Telecare – 5 DISTINCT ADVANTAGES
1
Over 8 Years
of Experience
in Working as
Vendors for
Major Health
Insurance
Companies
Across US
Deep
Knowledge of
the Payer
Side of the
US
Healthcare
Spectrum
2
Consistent
Performance
in Delivering
97%
Collection
Rate to
Clients
Already
Recovered
over millions
in Account
Receivables
and
continuing…
3
The Only
Medical Billing
Company with
Its Own State-
of-the-Art
Telemedicine
Platform
4
The Best
References
in Every
Segment
of US
Healthcare
Knowledge &
Business
Process
Outsourcing
5
The Lowest
Prices* in the
Market!
* Only $10 / hour
for a dedicated and
knowledgeable
billing expert
working on the
client account

 Very Little Risk
• Proven track record in providing healthcare BPO/KPO services
• Experienced in providing services to both payers and providers
• Experienced working with various software platforms
• Quick and efficient resource for special projects requiring technical and process expertise
 Significant Upside Potential
• Great understanding of the Healthcare Industry. Operation scale-up with a short notice
• Extremely competitive rates, greater productivity, improved quality, increased member and provider
satisfaction
 Proven Process Performance
• Low denial rate  reduced collection time  increased revenue collection
• Billing & Coding Accuracy > 99.9%; TAT: 24 – 48 hours
• Adherence to CMS billing requirements
 Clear Communication and Quick Response Time at All Times
 ISO 27001:2005 & HIPAA Compliance for End-user Data Privacy and Protection
WHY US?
12Private & Confidential© GoTelecare 2015-16| All Rights Reserved

MORE INFORMATION
GoTelecare
Ronnie Hastings
41 Madison Avenue, 25th Floor,
New York, NY 10010
Phone: +1 6466617853
E-mail: ronnie.hastings@gotelecare.com
For Additional Information, Please Contact…

GoTelecare Medical Billing & Coding Services

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