This document provides an overview of a company's revenue cycle management services. It discusses their experienced team, the full scope of services they provide including medical billing, coding, insurance verification and collections. It outlines their unique process for outsourcing these services which includes analyzing needs, establishing pilot programs, and specialized oversight teams. Graphical representations are also included showing the overall billing cycle and common reports generated from their services. Their specialties in various medical fields are listed at the end.

1. REVENUE CYCLE MANAGEMENT
PRESENTATION

2. Revenue Cycle Management

3. OUR TEAM
 Our Services, your Solution.
 Dedicated to providing your practice with the latest re-imbursement strategies.
 Achieving higher re-imbursement in a timely manner.
 High experienced and motivated skills in healthcare industry to take your practice to the
next level.
 Complete Practice Management services & solutions to maximize your re-imbursement.
 Providing services with fast, efficient & reliable service to our clients and their patients
while maximizing our client’s income level.

4. WHY US?
We assist you to;
 Focus on quality patient care.
 Focus on strategy to acquire new patients.
 Focus on policy and compliance.
 Focus on superior patient relations.
 Expedite and enhance revenue generation.
 Enhancing your productive office hours.
 Improve claim accuracy.
 Reduce office expenses.

5. WHAT WE DO?
Our team will provide various services covering the entire
spectrum of the revenue cycle, including;
 Appointment Scheduling
 Patient Registration/Enrollment
 Insurance Eligibility Verification
 Pre-Certification/Pre-Authorization
 Medical Coding
 Medical Billing/Charge Capturing
 Claims Transmission
 Payment Posting
 Denial Management
 Insurance Follow-up
 Self Pay Follow-up

6. HOW WE DO?
 We have a unique process to ensure your outsourcing success. Regardless of where you
are, depending on your needs we can cater to your requirements.
 We analyze the situation to understand your needs.
 We conduct a comprehensive study of the processes involved and give our input on the
components of your business.
 We establish a pilot project. We will clearly define parameters of quality, productivity, turn
around time, and cost efficiency. Pilot program is carried out over a 30 day period, but this
could vary depending on the service you are seeking.
 We have a specialized team who would work with you and the execution team to make
sure that standards and efficiency do not drop. The objective of this stage is to consistently
meet expectations.
 We ensure that you not only have a comfortable outsourcing experience, but never lose
control over the entire process.

7. OUT PATIENT BILLING SERVICES CYCLE
Pre-Certification/ Pre-
Authorization
Patient Statement
Medical Coding
Insurance Verification
and Eligibility
Patient Demographic
Entry
Charge Entry
Cash / Payment
Posting
AR/Denial
Claims Submission
Scheduling and Patient
Registration
Monthly Reports

8. Scheduling and Patient Registration
We have Few options for your practice to Make your Patients Next Appointment Scheduling Stress
Free.
We help our customers schedule their appointment according to the mutual convenience of Physician
and Patient.
We assist our customers in migrating to electronic scheduling for effective scheduling.
This helps us to manage Physician’s as well as Patient’s time effectively.
Patient Registration
Capturing patient’s demographic information accurately to submit Clean Claims to various insurance
carriers.
Reduce delays in claim submission
Rigorous controls in the data capture process helps to ensure 100% accuracy for critical information
following HIPPA Law.

9. PRE-CERTIFICATION/PRE-AUTHORIZATION
o We coordinate with insurance carriers to get pre-authorization or pre-certification identity
details to manage receivables better and collect dues on time from insurance carriers.
o Receive timely Pre-Auth / Pre-Cert ID details from insurance carriers.
o Get paid on time.
o Minimizing risk related to Patient Identification.
o This helps to manage the receivables better and collect dues on time from insurance
carriers.

10. Insurance Verification and Eligibility
Eligibility / Benefits verification is a very important process in overall revenue cycle management.
Eligibility verification is the most efficient way to eliminate denials. As soon as our team gets the list
of scheduled patients they get right to work.
Verification team accesses payer’s website / portals, AVR systems and also speaks to the Insurance
Company’s reps to get the required information.
Our team runs through a standard list of verification questions to confirm the patient’s eligibility and
coverage for the services to be provided. This includes coverage limits, effective dates, Co-pays,
deductibles, Out of pocket expenses, Referrals & Authorizations.
As soon as the required information is verified, we immediately report back to our clients with the
required reports or by directly entering the information in the Medical Billing software.

11. Patient Demographic Entry
Our accurate data processing ensures clean claims and does reduce denials drastically. Our
experienced team registers all patients information with high accuracy. We ensure to choose the
correct Insurance codes from the Insurance master list. We capture specific information based on
the software and specialty. We have the ability to make accurate entries looking at scanned
images.
Our demographics registration process accurately captures patient, guarantor and insurance
informations.
Our process includes the following checks:
New patient or existing patient
If new patient, capture all required information
Existing patient – Update latest insurance, patient and guarantor information

12. Medical Coding
We offer flexible medical coding services helping our clients to reduce their denials and
optimize their revenues. Our Medical Coding team of professional coders are well experienced
in procedural and diagnostic coding.
We ensure all performed / documented procedures are coded accurately. Our medical coding
services will reduce your compliance risk and help you stay focused more on your core
activities. We clearly understand the liability issues associated with incorrect coding and thrive
to deliver with high quality.
Our certified medical coding professionals focus to avoid any down coding or up coding. We
strive hard to be accurate and assign our coders to any project based on the specialty. We can
assist you immediately on your short term or long term coding assignments.

13. Charge Entry
Our team has the ability to process both manual and review electronic charge entries available
in EHR / EMR. We capture all relevant information from the super-bill like
Performing Provider, Referring Provider, Date of Services, Location, Place of Services, Type of
Service, Admission Date, Discharge Date, Number of units, Authorization Numbers,
Referral Numbers, ICD Codes, CPT Codes, Modifiers etc.,
Our team has the experience to link the correct ICD codes to each CPT code avoiding
unnecessary rejections and denials.

14. Claims Submission
Electronic Claims submission
Submitting claims through EDI reduces processing delays and ensures higher acceptance rates with
Payers.
The team for each client typically identifies one key member to be responsible for the EDI. This person is
responsible for
•Daily EDI transmission of claim batches
•Track the EDI transmission reports every day
•Identify ‘rejections’ from EDI transmission reports
•Send rejections back to Billing team for fixing the error
•Co-ordinate with Clearing House and resolve any field mapping issues.

15. Cash / Payment Posting
Our Cash / Payment posters have the ability to do:
•Auto Posting from ERAs (Electronic Remittance Advice)
•Manual Posting from EOBs (Explanation of Benefits)
Our Workflow:
• Accurate posting of remittances, matching and accounting for every penny
• Submission of Secondary Claims
• Generating Patient Statements
• Denials Capture
• Batch Status report to clients

16. AR/Denial
We clearly understand account receivable is the vital part of any business. Our experienced
billers use various follow-up methodologies to ensure prompt payment.
We run aging reports to categorize [Oldest to Latest & Highest to Lowest] outstanding claims
and follow-up with carriers. We help improve revenue realization.
Denial Management
We conduct thorough analysis of every denied claim, make the necessary corrections, and
follow-up to convert it into a clean claim.
We help improved revenue realization.
We help introduce preventive measures for future billing.
We keep a good track of outstanding accounts and follow-up on time providing maximized
revenues.
We have established clear productivity and performance metrics helping our clients to have
total control of the process and results.

17. Patient Statement
 Review key information about each account, such as the account type, the date and
amount of the last responsible party payment that was received, any unapplied money
sitting in the account, and the balance owed on the statement.

18. Reports
Reports can show you how your practice is performing on important revenue cycle metrics, whether
claims are being paid in a timely fashion and and how well insurance carriers are paying you for key
procedures, among other things.
Account Receivable Aging Report
The A/R Aging Report breaks down claims based on the number of days they’ve been in receivables
(in other words, the number of days they’ve been unpaid).
Key Performance Indicators (KPI)
This report tracks total encounters; total number of procedures; total charges; total collections;
outstanding A/R; and total adjustments. This report helps to to compare a variety of indicators from
month to month and identify both positive and negative trends.
Top Carrier/Insurance Analysis Report
Tracks the charges, payments and collections of top 10 carriers, the payers and insurance companies
that make up the majority of payments. The report also tracks payments, collections and CPT codes
and units, allowing the practice to drill down into the charges, payments and collections for a specific
CPT code. This report also provides important information practices can use to negotiate better
pricing with payers and insurance companies.

19. OUR SPECIALITIES
Our specialties are in the field of:
 General Practitioners
 Out-patients
 In-patients
 Home Visit
 Nursing Home
 Physical Therapy
 Pediatrics
 Psychiatry

20. THANK YOU
 Thank you for your time and attention!
 Contact us for more information about Revenue Cycle
Management Services
 Reach out to ssbillingservice@gmail.com