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Revenue Cycle Management for Oncology by Sun Knowledge
1.
REVENUE CYCLE MANAGEMENT SERVICES FOR
ONCOLOGY
2.
SUN KNOWLEDGE OVERVIEW Key
Facts Awards, Affiliations & Certifications 2Sun Knowledge © 2015-16 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 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 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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 Payors – Commercial Plans, MA Plans, Medicaid HMOs, MAPD/PDPs, IPAs, MSOs, TPAs, PBMs and RBMs 3Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA
4.
SERVICE PORTFOLIO SUMMARY 4Sun
Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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
5.
SERVICE AREAS 5Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA We provide revenue cycle management services in the following areas: Durable Medical Equipment Prosthetics & Orthotics Urgent Care Pathology Critical Care Skilled Nursing Facilities Wound Care Oncology Pharmacies Cardiology Specialty Clinics Orthopedic Surgery Anesthesia Family Practice Radiology Rehab Centers Dermatology Physicians Healthcare Facilities and more…
6.
SERVICE HIGHLIGHTS 6Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Up to 97% collection rate in accounts receivable FREE medical billing software, EMR & setup Real-time eligibility checks & fast authorization 100% HIPAA-HITECH compliance Claim status analysis using Rapid Automation Technology® 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
7.
OUR HIPAA COMPLIANCE
SUMMARY 7Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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
8.
8Sun Knowledge ©
2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA REVENUE CYCLE MANAGEMENT
9.
REVENUE CYCLE MANAGEMENT
– KEY PROCESSES 9Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 360° Revenue Cycle Management Services Eligibility & Authorization Verification Patient Information Entry Coding Charge Entry Claim Submission Payment Posting Accounts Receivable Denial Management Reporting
10.
IMPORTANT TASKS 10Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Inpatient/Outpatient Hospital Coding Physician Coding Patient entry demographics & insurance information Fee Schedule / Charge Entry Scrubbing all entries for correctness and completeness with 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, 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 CODING BILLING A/R FOLLOW-UP
11.
THE REVENUE CYCLE
MANAGEMENT EXPERIENCE 11Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA HOSPITAL Accounts Receivables Follow - Up Denial Management Claims Resubmission DME Order Entry Eligibility Verification/ Authorization Follow up on Auth Approval Delivery Scheduling Submission of claim Rejection Management Payment Posting A/R Follow-Up Denial Management CPAP Compliance Tracking O&P Rx Order Entry Patient Demographics and Insurance Entry Product Code entry/Rx & Dx Entry Eligibility Verification/ Authorization Collection of complete Rx Collection of Documents for Auth Approval Submission Rejection/Denial Management A/R Follow-Up URGENT CARE Order Entry – Patient Information, Ordering Physician, Rx & Diagnosis Eligibility Verification Medical Document Collection Authorization Approval Order Audit Confirmation Submission of Claims Rejection Management Payment Posting A/R Follow-Up Patient Entry: Demographics & Insurance Eligibility Verification Authorization Follow-Up Charge Entry Submission of Claims (EDI/Paper) Rejection Management Payment Posting A/R Follow-Up Denial Management PHYSICIAN Patient Entry: Demographics & Insurance Charge Entry Submission of Claims (EDI/Paper) Rejection Management Payment Posting A/R Follow-Up Denial Management HOME HEALTH
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MEDICAL BILLING CYCLE 12Sun
Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Rx Order Entry Patient Demographics and Insurance Entry Product Code / Rx & Dx Entry Eligibility Verification/ Authorization Collection of complete Rx Collection of documents for Auth Approval Submission Rejection/Denial Management A/R Follow-up BILLING
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MEDICAL BILLING CYCLE 13Sun
Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Order entry based on the Rx received from the Physician • Patient demographics & insurance entry • Provider information entry • Product code entry • Rx & Dx entry (with appropriate timeframe) • If necessary, a telemedicine consultation can be completed to obtain a Rx to expedite the order entry process Eligibility verification and authorization requirement enquiry Collection of documents required by payer for auth approval, e.g. face-to-face consultation notes, and obtaining authorization from Payer Determination that Payer criteria is met before delivery of equipment, e.g. some products have time/frequency/ annual cost limitations f (if criteria is not met, the Patient is contacted and informed of the financial responsibility) Generation of delivery ticket (based on which delivery is made to the patient) Creation of claim after receipt of confirmation of delivery Submission of EDI / paper claim to payers Cash posting Rejection & Denial Management A/R follow-up BILLING
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MEDICAL BILLING SYSTEM 14Sun
Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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 payor billing Denial Management Patient statement generation and mailing Sun Knowledge handles medical billing - promptly, perfectly and professionally – using Kareo® or other billing systems as preferred by the client. BILLING
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MEDICAL CODING OVERVIEW 15Sun
Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Service Offerings • Place of Service Based Coding – Inpatient, Outpatient Coding • Provider Specialty Based Coding– E/M, Cardiology, Orthopedics, Physical Medicine etc. • Review medical notes and clinical documents • Assign ICD-10 codes for the diagnosis identified by the physician and Procedure codes (CPT/ ICD 10 PCS) • Assign modifiers as applicable • Code review and quality assurance • Communication with Physician’s office for additional medical documentation and clarification Key Tasks CODING
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MEDICAL CODING –
PROCESS 16Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Downloading Allocation CodingQuality Check Uploading Feedbacks & Updates Encrypted reports are downloaded from SFTP site Reports are allocated to coders according to specialty Quality checked for LCDs, updates and client specs. Analysis of reports, allocation of ICD and Service codes Analysis of reports, allocation of ICD and CPT codes Client reports back with feedbacks and updates Medical Coding Process Flow CODING
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MEDICAL CODING –
HIGHLIGHTS 17Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA • Our coders deliver error-free charge sheets within agreed TAT provided by the client • We monitor, analyze and improve coding documentation to avoid denials and guarantee reimbursements • We carefully determine the codes according to the clinical information provided by the Healthcare Provider/Professionals and report back accordingly • Our coders have undergone extensive medical coding training and are well aware of updated coding guidelines • All our coders are ICD-10 certified (CPC) CODING
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ELIGIBILITY & AUTHORIZATION
VERIFICATION 18Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA • Full range of verification services • Fast 24-hour turnaround time • 96 – 99.9% accuracy • Detailed documentation • 100% HIPAA compliance • Experience with national and private carriers VERIFICATION • Diligent follow-up till resolution and closure • Uniform importance given to every account irrespective of size, age or claim value • Fast completion of authorization process • Periodic follow-ups to maintain authorization validity ELIGIBILITY VERIFICATION AUTHORIZATION VERIFICATION
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SAMPLE REPORTS 19Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 0 20 40 60 80 100 120 140 4/6/2015 4/7/2015 4/8/2015 4/9/2015 4/10/2015 96 83 94 98 96 29 11 6 31 32 125 94 100 129 128 41 32 26 30 28 ELIGIBILITY VERIFICATION Number of New Patient Patient Brought Forward Primary Checked Secondary Checked (if applicable) 0 5 10 15 20 25 30 35 40 45 50 4/6/2015 4/7/2015 4/8/2015 4/9/2015 4/10/2015 45 25 38 44 46 20 15 26 22 21 25 10 12 22 25 AUTHORIZATION VERIFICATION Auth Required Auth Obtained Auth Pending VERIFICATION
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PRIOR AUTHORIZATION 20Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA • Full Range Service Authorization Request Follow-up Approval • 100% HIPAA-HITECH Compliance • Low prices with no hidden cost • Highly streamlined, fast and accurate service • Imaging Techniques for Screening and Identification of Cervical Cancer • Autologous Cellular Immunotherapy • High Intensity Focused Ultrasound (HIFU) • Hyperthermia for Cancer Therapy • Cytoreduction, hyperthermic intraperitoneal chemotherapy (HIPEC) • Cryosurgical ablation of tumors • Radiation Oncology • Organ, Bone Marrow, Stem Cell Transplants and other similar procedures • Other conditions We cater to PRIOR AUTHORIZATION
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ACCOUNTS RECEIVABLE 21Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA ACCOUNTS RECEIVABLE Our A/R follow-up service is designed to increase the Revenue Collection for our clients. The process begins after the Provider creates and sends Health Insurance Claims (Electronic/Paper claims or Manual HCFA forms) to various Insurance Companies. Depending on the transmission type and length of time since submission, we begin our follow-ups.
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STEPS IN AR
FOLLOW-UP 22Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA ACCOUNTS RECEIVABLE A/R Analysis 14% of all claims submitted to the payers are denied and have to be resubmitted, appealed or written off by providers 50% of denied claims are never re-filed 50-70% of denied claims have higher chance of being recovered Follow-up with payer Aggressive follow up with the insurance company's on all accounts at any stage of the aging bucket plays an important part in A/R follow up activities. Closure of claim Reducing days in A/R, claims submission and improving collection ratio with an increase in the probability of payment through timely follow-up is the responsibility of the A/R team
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DENIAL MANAGEMENT 23Sun Knowledge
© 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA ACCOUNTS RECEIVABLE Claim Correction and Resubmission These are the claims which are corrected, modified, and resubmitted as a corrected claim to Insurance companies. For such claims, every effort is made to resolve the denial to avoid billing the patient. Patients' Responsibility These are claims which cannot be further worked upon and the final bill is sent to the patient for payment collection. The reasons for sending the patient a bill generally include In-Network deductibles and non-covered benefits as per the insurance plan. Patients receive a statement with a clear explanation for the balance due. 1 2 2 Categories of Denial Management
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DISTRIBUTION OF DENIED
CLAIMS 24Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA ACCOUNTS RECEIVABLE 24% 11% 3% 35% 17% 10% Distribution of Denied Claims Auth Related Coding Correction Required OON Issue Others Patient info missing Timely Filing
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AR AGING REPORT
SAMPLE 25Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA ACCOUNTS RECEIVABLE SUN KNOWLEDGE WEEKLY AR AGING REPORT FOR Client X Inc. - 07/06/2015 through 07/12/2015 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 BCBS 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 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
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THE SUN KNOWLEDGE
ADVANTAGE 26Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA Increased revenue – reduced collection time (95% + collection rate) Reduction in accounts receivable by 30% within 1 month Expert handling of accounts receivable by highly experienced staff with demonstrated expertise Claim submission within 48 hours of receipt of billing input Provider can focus more on core services Adherence to CMS billing requirements Proper records maintenance and visibility through reporting
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27Sun Knowledge ©
2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA CHALLENGES & RESPONSES
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CHALLENGES & OUR
APPROACH 28Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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
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CHALLENGES & OUR
APPROACH 29Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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
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CHALLENGES & OUR
APPROACH 30Sun Knowledge © 2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA 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
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SUMMARY OF BENEFITS 31Sun
Knowledge © 2015-16 Private & Confidential 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 increase in revenue collection • High billing & coding accuracy; TAT: 24 – 48 hours • Adherence to CMS billing requirements Clear Communication and Quick Response Time at All Times ISO 27001:2013 & HIPAA Compliance for End-user Data Privacy and Protection 41 Madison Avenue, 25th Floor, New York, NY 10010, USA
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32Sun Knowledge ©
2015-16 Private & Confidential 41 Madison Avenue, 25th Floor, New York, NY 10010, USA TESTIMONIALS
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CLIENTSPEAK 33Sun Knowledge ©
2015-16 Private & Confidential “We have had the pleasure of working with the Sun Knowledge team throughout the few months utilizing their services for patient data entry and eligibility verification. They are a devoted and responsible team that is highly experience in what they do. They are always concerned about the client’s needs and are always there to help. I highly recommend the services offered by Sun Knowledge.” COO of a leading medical billing and credentialing company in New York “Your team amazed me with the manual and the amount of info you provided with that short training session.” Practice Manager of a major Dermatology group in New York and New Jersey 41 Madison Avenue, 25th Floor, New York, NY 10010, USA
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CLIENTSPEAK 34Sun Knowledge ©
2015-16 Private & Confidential “My firm has evaluated an outsourcing transaction with Sun Knowledge. They provide superior service at a very attractive rate and have demonstrated to us their commitment to this partnership. Their expertise across various process areas in the PDP/MAPD domain and unique cost structure puts them in an incredible position to work with plans throughout the healthcare industry.” Chairman, President and CEO of a major New York based Health Plan “Our company is very pleased with the administrative, and business analytical solutions which Sun Knowledge delivers to our company from a quality & cost perspective. They have been a true partner in bringing industry expertise, and innovative solutions to the table. Their ability to grow with our evolving needs for higher end services such as clinical services is a significant differentiator among healthcare business process outsourcing firms.” Executive Vice President of Operations of a leading MSO 41 Madison Avenue, 25th Floor, New York, NY 10010, USA
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CLIENTSPEAK 35Sun Knowledge ©
2015-16 Private & Confidential “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 Ronnie Hastings (646) 661-7853 Email: ronnie.hastings@sunknowledge.com Sun Knowledge 41 Madison Ave., Suite 2511, 25th Floor New York, NY 11001, USA For Additional Information, Please Contact… 41 Madison Avenue, 25th Floor, New York, NY 10010, USA
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