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.
Sun Knowledge Revenue Cycle Management ServicesSun Knowledge
Sun Knowledge Revenue Cycle Management gives you a clear visibility of your finances through payment follow-up. Prosthetics and orthotics billing are handled diligently.
Revenue or yield management in hotels is a practice that has evolved significantly in its relatively short history. Adopted by hotels in the late 1980s, after the airline industry demonstrated great success using inventory, capacity and pricing to ‘manage’ revenue, revenue management has become one of the most integral and identifiable aspects of hotel operating strategy. Yet perhaps understandably, today’s brand of hotel revenue management differs significantly from that of two decades ago. Changes in the general approach to revenue management, pricing strategy, channel management, inventory allocation and the use of information as pertains to revenue management have redefined the field.
Dan Wellisch gave this presentation to the Chicago Technology For Vaue Based Healthcare Meetup at https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
Sun Knowledge Revenue Cycle Management ServicesSun Knowledge
Sun Knowledge Revenue Cycle Management gives you a clear visibility of your finances through payment follow-up. Prosthetics and orthotics billing are handled diligently.
Revenue or yield management in hotels is a practice that has evolved significantly in its relatively short history. Adopted by hotels in the late 1980s, after the airline industry demonstrated great success using inventory, capacity and pricing to ‘manage’ revenue, revenue management has become one of the most integral and identifiable aspects of hotel operating strategy. Yet perhaps understandably, today’s brand of hotel revenue management differs significantly from that of two decades ago. Changes in the general approach to revenue management, pricing strategy, channel management, inventory allocation and the use of information as pertains to revenue management have redefined the field.
Dan Wellisch gave this presentation to the Chicago Technology For Vaue Based Healthcare Meetup at https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
Hospitals and health systems are struggling to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, suggests a HFMA/Navigant survey of 125 provider CFOs and revenue cycle management executives.
Healthcare Industry Highlight: Revenue Cycle ManagementCascadia_Capital
In our most recent Healthcare Industry Highlight Report on Revenue Cycle Management, we outline the trends driving consolidation and increased market activity and make predictions on the outlook and future of the RCM ecosystem.
e-care - Healthcare Revenue Cycle Management ecare India
e-care India is one of the leading medical billing companies in India that provides wide range of services to physicians, hospitals and medical billing companies in the United States.
e-care, founded in early 2000 is a pioneer in the field and now employs 1000+ people with varied expertise to match to the growing needs of the business.
e-care is a pioneer in the medical billing field and the first Indian medical billing company to get ISO 27001:2005 certified for information security management. e-Care is also an ISO 9001:2008 certified medical billing company for quality management. e-Care ensures that all the changes and updates made by HIPAA are properly and correctly communicated amongst the team to ensure highest standards of security and confidentiality.
e-care provides end-end medical billing services including but not limited to Healthcare revenue cycle management, Physician credentialing, Indexing medical records, Insurance eligibility verification, Data Entry services, Medical coding services, Accounts receivable management, and Medical billing data migration.
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
What is revenue cycle management? How does it impact your practice’s ability to maintain profitability? What are the critical steps to take when managing your revenue cycle? This Quirk Healthcare Solutions Insights webinar will lead you through the important healthcare provider business practice of revenue cycle management. We’ll discuss the stages of RCM, development of a fee schedule, establishing financial policies, billing and collection cycles, and the practical application of revenue cycle management.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
Vee Technologies provides a host of hybrid and versatile solutions for credentialing services. Our team expertly handles payer enrollment and contracting for our clients, turning an arduous task into a quick and easy process.
https://www.veetechnologies.com/industries/healthcare-payer/provider-network-data-management/credentialing.htm
Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
Revenue Cycle Management: Market Dynamics & Opportunities in a Changing Healt...Cognizant
Sourcing revenue cycle management can help healthcare insurers overcome growing reimbursement complexities. Yet providers say managing dozens of RCM vendors comes with its own complications. That’s why they’re increasingly sourcing comprehensive RCM solutions with a single vendor to generate greater efficiencies, reduce costs and improve patient satisfaction.
Claim denials are costly. Learn the basics of establishing a strong denial management process and strategies to place your focus on denial prevention. Learn to reduce your costs associated with collection on your claims, reduce your days in AR and maintain a healthier Revenue Cycle.
Hospitals and health systems are struggling to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, suggests a HFMA/Navigant survey of 125 provider CFOs and revenue cycle management executives.
Healthcare Industry Highlight: Revenue Cycle ManagementCascadia_Capital
In our most recent Healthcare Industry Highlight Report on Revenue Cycle Management, we outline the trends driving consolidation and increased market activity and make predictions on the outlook and future of the RCM ecosystem.
e-care - Healthcare Revenue Cycle Management ecare India
e-care India is one of the leading medical billing companies in India that provides wide range of services to physicians, hospitals and medical billing companies in the United States.
e-care, founded in early 2000 is a pioneer in the field and now employs 1000+ people with varied expertise to match to the growing needs of the business.
e-care is a pioneer in the medical billing field and the first Indian medical billing company to get ISO 27001:2005 certified for information security management. e-Care is also an ISO 9001:2008 certified medical billing company for quality management. e-Care ensures that all the changes and updates made by HIPAA are properly and correctly communicated amongst the team to ensure highest standards of security and confidentiality.
e-care provides end-end medical billing services including but not limited to Healthcare revenue cycle management, Physician credentialing, Indexing medical records, Insurance eligibility verification, Data Entry services, Medical coding services, Accounts receivable management, and Medical billing data migration.
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
What is revenue cycle management? How does it impact your practice’s ability to maintain profitability? What are the critical steps to take when managing your revenue cycle? This Quirk Healthcare Solutions Insights webinar will lead you through the important healthcare provider business practice of revenue cycle management. We’ll discuss the stages of RCM, development of a fee schedule, establishing financial policies, billing and collection cycles, and the practical application of revenue cycle management.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
Vee Technologies provides a host of hybrid and versatile solutions for credentialing services. Our team expertly handles payer enrollment and contracting for our clients, turning an arduous task into a quick and easy process.
https://www.veetechnologies.com/industries/healthcare-payer/provider-network-data-management/credentialing.htm
Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
Revenue Cycle Management: Market Dynamics & Opportunities in a Changing Healt...Cognizant
Sourcing revenue cycle management can help healthcare insurers overcome growing reimbursement complexities. Yet providers say managing dozens of RCM vendors comes with its own complications. That’s why they’re increasingly sourcing comprehensive RCM solutions with a single vendor to generate greater efficiencies, reduce costs and improve patient satisfaction.
Claim denials are costly. Learn the basics of establishing a strong denial management process and strategies to place your focus on denial prevention. Learn to reduce your costs associated with collection on your claims, reduce your days in AR and maintain a healthier Revenue Cycle.
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 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.
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.
Welcome to Sun Knowledge for cost-effective solutions in healthcare outsourcing, including medical coding & billing, revenue cycle management, account receivables management and more.
The only business opportunity that combines Telemedicine, Remote Patient Monitoring and Revenue Cycle Management for exciting prospects and super growth potential
Go Telecare Franchise Opportunity OverviewMichael Smith
GoTelecare welcomes you to be a part of an exciting new franchise opportunity that combines a cutting-edge Remote Patient Monitoring (mHealth) service, with a state-of-the-art Telemedicine platform, and end-to-end Practice Management & Revenue Cycle Management.
If you are a motivated entrepreneur who thrives on business development, wants zero operational headache and is curious about telemedicine's explosive national growth, this is the opportunity you've been waiting for!
As a franchisee, you will offer healthcare clients services for telehealth and low cost medical billing. Clients vastly range from physician individual practices to nursing homes, hospitals and many other healthcare organizations. No operational headaches, unlike any other franchise opportunity! As a franchisee, you will build a telehealth network consisting of providers and healthcare facilities also offering them a tried and true medical billing service. Franchisee's main objective is client acquisition and minor account management - We take care of all the rest, you collect on-going residual income!
Complete Prior Authorization Services | Prior Authorization Process GuidelineMichael 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
We act as the perfect facilitator between you & the Payer, eliminating all errors in the process of Pre-certification. Our full suite of Practice Management services includes a comprehensive and highly streamlined prior approval process that includes a) sending out the auth request, b) following up with the Payer, and c) obtaining the approval.
In addition, we also extend our support with fast and accurate patient eligibility verification and benefits verification that help prevent nasty surprises at the time of seeking reimbursement from insurance companies.
Looking for proven expertise in a dedicated niche? That's us!
As a disciplined vendor, we aim to centralize practices,
streamline them, reduce errors and improve overall efficiency.
Key Benefits
~ 70% reduction of operational cost... guaranteed!
~ Increase your current rate of successful authorizations by 1.5 – 2x
~ Full-range Prior Authorization service (Auth Request + Follow-up + Approval)
~ Prompt service with 99.9% accuracy
~ 100% HIPAA compliance
~ Highly competitive prices, with no overhead - no overtime - no hidden costs!
~ 7+ years of experience in claims adjudication for leading Payers
~ Free your in-house team for focusing on care management issues
~ Zero lockup service contracts that you can cancel anytime
WHAT WE COVER
We do prior authorization for DME (Durable Medical Equipment), CPAP Machines, Orthotics & Prosthetics, Allergy, Oncology, Physician Services, Nursing Homes, Radiology, Specialty Pharmacy, Home Healthcare, Anesthesiology, Dermatology, Imaging, Rehab, Cardiology, Physical Therapy, Sleep Medicine, Gastro Enterology, Pain Medicine, Rheumatology, Clinical Care Management, Podiatry, Neurology,
Pulmonology, Urology, General Surgery, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Otolaryngology Medical Practice and more!
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.
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.
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.
Telehealth and Medical Billing both Franchise Opportunity together at Low CostMichael Smith
About GoTelecare:
GoTelecare offering business opportunity that combines Remote Patient Monitoring (mHealth), Telemedicine and Practice Management or Revenue Cycle Management for super growth.
Contact GoTelecare Telehealth and Medical Billing Franchise
Website - http://www.franchise.gotelecare.com/healthcare-franchise
Phone - 646-661-7853
Address - 41 Madison Avenue, 25th Floor, Suite 2511, NY - 10010
Start exploring the GoTelecare partnership opportunity today !
Franchise Partner Opportunity:
GoTelecare welcomes you to be a part of an exciting new franchise opportunity that combines a cutting-edge Remote Patient Monitoring (mHealth) service, with a state-of-the-art Telemedicine platform, and end-to-end Practice Management & Revenue Cycle Management.
If you are a motivated entrepreneur who thrives on business development, wants zero operational headache, is curious about telemedicine's explosive national growth.
2 IN 1 Partnership Opportunity - Telehealth & Medical Billing:
As a franchisee, you will offer healthcare clients services for telehealth and low cost medical billing. Clients vastly range from physician individual practices to nursing homes, hospitals and many other healthcare organizations.
No operational headaches, unlike any other franchise opportunity! As a franchisee, you will build a telehealth network consisting of providers and healthcare facilities also offering them a tried and true medical billing service. Franchisee's main objective is client acquisition and minor account management - We take care of all the rest, you collect on-going residual income!
GoTelecare Healthcare Franchise FAQ:
How big is my territory and how are they defined?
We have utilized state of the art geographical territory mapping software to create territories which identify client opportunities based off of a specific area. Although territories are different in geographic size, territories are of equal value nationally.
Who are all of the client targets I can pursue for medical billing?
DME, Home Healthcare Agencies, nursing homes, assisted living facilities, physician offices, Physical Rehabilitation Centers, Assisted Living Facilities, Public & Private Education Facilities, Pharmacies, Correctional Facilities, Ambulate Services, Medical Labs & Imaging Services, Health Insurance Co.
What is the royalty fee?
There are no royalty fees, unlike most other partnership models. GoTelecare has a unique revenue sharing model which we will be happy to explain. Please inquire via the contact form below to speak with one of our experts.
How long does it take to open a new location?
Right away! Unlike most other similar models, there is no required brick and mortar location, so you can begin immediately.
Do I need previous healthcare experience?
No, we actively seek qualified partners from varied backgrounds.
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.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
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Sun Knowledge - Practice Management and Revenue Cycle Management Services PPT
1. PRACTICE MANAGEMENT
& REVENUE CYCLE
MANAGEMENT SERVICES
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, Laboratories, 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. SERVICE PORTFOLIO
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. SERVICE AREAS
We provide revenue our services in the following areas:
Nursing Homes Prosthetics & Orthotics Urgent Care
Durable Medical Equipment Dentistry Skilled Nursing Facilities
Wound Care Pain Management Pharmacies
Cardiology Specialty Clinics Orthopedic Surgery
Physical Therapy Family Practice Radiology
Rehab Centers Dermatology Diabetics
Healthcare Facilities and more…
Private & Confidential 5Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
6. SERVICE HIGHLIGHTS
Up to 97% collection rate
Instant reduction of billing cost by 70%
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
* Conditions apply
Private & Confidential 6Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
7. 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 7Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
8. REVENUE CYCLE
MANAGEMENT
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 – 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 9Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
10. IMPORTANT TASKS
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
Private & Confidential 10Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
11. MEDICAL BILLING CYCLE
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
Private & Confidential 11Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
12. MEDICAL BILLING CYCLE
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
Private & Confidential 12Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
13. MEDICAL 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
Sun Knowledge handles medical billing - promptly, perfectly and
professionally – using Kareo® or any other billing system as
preferred by the client.
BILLING
14. MEDICAL CODING OVERVIEW
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
Private & Confidential 14Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
15. MEDICAL CODING – PROCESS
CODING
Private & Confidential 15Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
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
16. MEDICAL CODING – HIGHLIGHTS
• 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
Private & Confidential 16Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
17. ELIGIBILITY & AUTHORIZATION VERIFICATION
• 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
Private & Confidential 17Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
19. PRIOR AUTHORIZATION
• Full Range Service (Authorization Request Follow-up Approval)
• 99.9% accuracy
• 100% HIPAA-HITECH Compliance
• Low prices with no hidden cost
• Highly streamlined, fast and accurate service
• Physical Therapy
• Nursing Homes
• Specialty Clinics
• Skilled Nursing Facilities (SNF)
• Diabetes
• Outpatient Surgery requiring general anesthesia
• Inpatient rehabilitation – Treatment for alcohol or drug abuse
• Many other conditions…
We cater to
PRIOR
AUTHORIZATION
Private & Confidential 19Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
20. ACCOUNTS RECEIVABLE
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.
Private & Confidential 20Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
21. STEPS IN AR FOLLOW-UP
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
Private & Confidential 21Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
22. DENIAL MANAGEMENT
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
Private & Confidential 22Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
23. DISTRIBUTION OF DENIED CLAIMS
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
Private & Confidential 23Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
24. AR AGING REPORT SAMPLE
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
Private & Confidential 24Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
25. THE SUN KNOWLEDGE ADVANTAGE
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
Private & Confidential 25Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
26. CHALLENGES & RESPONSES
Private & Confidential 26Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
27. 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 27Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
28. 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 28Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
29. 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 29Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
30. SOCIAL MEDIA MARKETING
Private & Confidential 30Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
31. EVEN MORE BENEFITS
Private & Confidential 31Phone: (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!
32. SUMMARY OF BENEFITS
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
• Billing & Coding Accuracy > 99.9%; TAT: 24 – 48 hours
• Adherence to CMS billing requirements
Clear Communication and Quick Response at All Times
ISO 27001:2013 & HIPAA Compliance for End-user Data Privacy and Protection
Private & Confidential 32Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
33. TESTIMONIALS
Private & Confidential 33Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
34. CLIENTSPEAK
“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
Private & Confidential 34Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
35. CLIENTSPEAK
“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
Private & Confidential 35Phone: (646) 661-7853 | E-mail: ronnie.hastings@sunknowledge.com
41 Madison Avenue, 25th Floor, New York, NY 10010, USA
36. 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 36Phone: (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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