Healthcare

Rising cost of Healthcare, rampant changes in technology and emphasis on “pay for performance” are driving healthcare organizations to fine tune their processes to yield better results. Healthcare organizations are exploring opportunities where they can partner with Business Process Management companies that can facilitate redefining of their business model and can provide added value  as well as maximum operational output.

Committed to fulfill your Healthcare or Staffing needs

Avantha offers healthcare organizations a complete suite of solutions that span the entire value chain. Our solutions enable healthcare organizations to accelerate cash collections, increase revenue, reduce bad debt expense, convert fixed costs to variable costs, and ultimately enhance patient satisfaction. This allows healthcare organizations to reduce costs and improve quality. It also eliminates costs associated with staff recruitment and turnover, and can reduce costs for physical space.

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Electronic Data Management

Avantha leverages specialist domain knowledge, best-in-class practices and systematic process-improvement to deliver high-end Healthcare Services (RCM) to client needs in Business Process Transformations and Consultative Solutions by providing the following services

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Electronic archiving of Patient documents

ABS has been provides Electronic Archiving / Indexing services of demographic information (insurance cards, drivers license etc), medical records, super bills, prescriptions to Healthcare companies and other vital documents with an accuracy of more than 99.00%.  We have a proven track record of serving some of the biggest players in the Home Healthcare vertical.

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Release of Patient Information

ABS offers targeted HIPAA-compliant release of PHI services to Healthcare organizations.

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Data digitization

ABS provides data digitization services in situations when the client is sun setting its current system and planning to move to a new system any backlog where client is falling short of manpower and there is a lot of data entry work required to be done on client system.

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Eligibility Verification

Our approach to Eligibility and Benefit Management is to ensure that the patient account is set up with most updated insurance details so that a clean claim can be generated on  the very first submission for adjudication by the insurance company.

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Pre-Certification & Authorization Management

Reimbursement Improvement

Medical Billing Management

  • Flawless Data Capture Solutions
  • Trained Medical Billing Specialists
  • Everyday claim Submission
  • Everyday Payment (ERA / ERN / EOB / Exception / Denial) Posting
    Increased Revenue
  • Reduced Denials and Rejections
  • Increased Collections
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Pre Collect Services (Early Collections)

Timely filing of Claims is one of the key areas that ensures timely claim adjudication by Insurance companies . This has a direct impact on any health care organization’s collections.

Denials due to not meeting  timely filing limit is one of the very top reason for rejected claims generally seen by Healthcare organizations.

At ABS we facilitate our clients by following up on the claims at early stages to ensure that Insurance companies have received the claims on time. We follow up with Insurance companies post 20 days of claim submission to check the following :

  • Claim received by the Insurance company ? If not re bill the claim.
  • Claim Denied by the Insurance company ? If yes the see if re appealing can be done.
  • Claim paid by the company? Do verify payment posting in timely manner once all relevant information is received.

Regular AR Management

We understand the importance of proper analysis and timely follow up as Accounts Receivables is the most significant asset of all healthcare organizations.

Our skilled staff is trained to identify patient accounts that require follow-up and take the necessary action to collect unpaid/underpaid claims.

Our Expertise :

  • Thorough and daily analysis on underpaid and denied claims
  • AR Follow up on claims beyond 30+ days

Special AR Projects wind down and aged Collection

  • We undertake special projects for claims that are greater than 180+ day old and work on collections as well adjustments.
  • We undertake wind down projects where clients are shifting from an existing billing platform to a new one however they want the existing AR work to be done from the old application.

Download Case Studies

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Payment Posting and Reconciliation:

Payment posting and reconciliation is an integral part of Revenue Cycle management.

Our staff is high trained in the process and has experience of working in different client applications. Adopting smart and efficient workflow along with automation we have been able to decrease the month end closing time for this process for multiple clients.

Our Expertise

  • Team works in two shifts to ensure that there is no backlog in the process.
  • Timely month end closing.
  • Very low unapplied Cash.