Healthcare Outsourcing

The ITH Advantage

ITH has the expertise to offer integrated, efficient, accurate and cost-saving services in the following areas:

  • Medical Coding
  • Medical Billing
  • Accounts Receivables in Medical Claims
  • Patient Demographics
  • Medical Transcription

By partnering with ITH, clients shall achieve revenue enhancement and cost-savings through:

  • Streamlined end-to-end processes.
  • Effective and efficient services provided by competent healthcare experts in Coding, Medical Billing, Transcription, Government Regulations and Software Applications.
  • Accurate data management resulting in reduced denials.
  • Effective follow-up to maximize returns.
  • Virtual Private Network (VPN) that ensures security and integrity of data and clients records.
  • Fast turnaround and cycle time.

ITH process management and consulting services can reduce costs and enhance revenue for healthcare service providers, medical billing companies, hospitals and payer organizations. Clients will have access to state-of-art technology on real-time basis from ITH center in Chennai, India.

How do we enhance your revenue?

Our qualified staff and efficient system and processes will speed your administrative operations leaving our Clients more time to concentrate on their core business. In doing so, our clients will see an improvement in revenue, reduction in cost and increase level of customer satisfaction.

For Billing Companies:

  • Cleaner claims are submitted resulting in fewer errors and denials.
  • Our low cost structure but highly qualified staff enable us to analyse and resolve denials even follow-up and make collection on lower dollar claims.

For Hospitals :

  • Two dedicated teams who specialized in analysis and follow-up provides cleaner claims, fewer denials and improved cash flow.

Medical Coding

Service

Coding is done by a team of coders who are certified coders (CPC). We have a specialised team experienced in areas like ER, anesthesia, pediatric, podiatry and radiology. Our coding team consists of coders from various backgrounds like Dentists, Physiotherapists, Nurses, Pharmacists, Microbiologists and many other Life Science graduates. The team is headed by a Physician, who is also a certified Coder (CPC, CPC-H).

Process & Delivery

i. Client Requirement Analysis Study:

This process commences once a Client approved to conduct process study and to submit a presentation on the benefits of business process outsourcing. The study will determine the specialties covered, required cycle time, type of files, type of reports and formats required.

ii. Transfer of Files from Client:

Client sends scanned clinical information or patient charts to ITH through FTP site.

iii. Downloading and Allocation of Files:

The files received from Clients are downloaded by Medical Coding Team and assigned to appropriate Pre-Coders and Coders.

iv. Pre-Coding:

Once the downloaded files are assigned to designated team, the Pre-Coders enter details that include Place of Service, Name of Physician, Medical Record Number, Admission and Discharge, Referring Physicians and any price modifiers.

v. Coding:

Coding is done with the help of CPT Encoder Pro software. Using references such as ICD-9-CM and HCPCS Level II, certified Coders enter the details and these are further checked by the Coding Team for compatibility of diagnosis with the procedure code, usage of Modifier, linking correct diagnosis for the procedures performed which involves CCI edits.

vi. Quality Assurance

Quality analyses are done at two levels. The first level quality assurance will be conducted by the Team Leaders who will do a 100% check while a random check will be conducted at the second level. Close working relationship and constant interaction with the billing team also ensures that coding is done accurately.

vii. Uploading completed Files:

Upon completion of coding process, the files that have been checked by the Coding Team are then uploaded to Client's FTP site.

viii. Quality Assessment:

The coded files that are forwarded to Clients through ITH's FTP site will be checked for quality by the Clients that includes CPT, ICD and Modifiers.

ix. Client Feedback & Continuous Improvement:

Client feedback is an integral part of continuous improvement process at ITH. ITH seeks to continuously improve and refine its coding processes to ensure Clients receive the most accurate and reliable service. We have regular training sessions to update the Coders on various coding issues.

x. Clarification & Teleconference:

Any clarifications that are required are noted and documented and sent to Client for answers. Teleconference is conducted periodically to obtain updates from Clients.

xi. Data Security & Maintenance:

All scanned files are stored for a period of 3 months. All printouts are shredded once CD back-up is done. No record can be taken out from the premise and all employees are subjected to confidentiality agreement.

Medical Billing

HOW WE ARE UNIQUE IN HEALTHCARE SERVICES

Service & Benefits the ITH Advantage Services:

ITH Innovative Medical Billing provides an end-to-end modular but integrated billing solution to its customers. Besides, ITH seeks to improve the revenues of physician practices and hospital-based physicians. ITH has the competencies and infrastructure to work with healthcare service providers and medical billing companies. ITH systems can ride on Client's existing processes and software to give them quality and fast turnaround time on their data processing functions. ITH systems can adapt to any software that the Client has without having to make new investment to accommodate the billing process. ITH expertise in medical billing and technology helps Clients to enhance revenue through prompt medical billing and cost -saving on the Clients' staffing operating expenditures.

Expertise:

ITH offers expertise on various billing software applications that include Medic, Medics II, Medisoft, Lytec, Sequelmed, Vision, Sourceone Med and IDX. ITH's team is fully competent and trained in regulations pertaining to Medicare, Medicaid, Third Party Liability, Workers Compensation, Preferred Provider Organizations, and Indemnity Insurers. The team has full understanding of CPT, HCPCS, ICD-9 coding level I, II and III and able to submit clean insurance claim for reimbursement by insurers.

Infrastructure:

ITHs comprehensive and integrated infrastructure includes:

  • Built in IT redundancies for uninterrupted operation
  • Independent internet Leased Circuits from multiple ISPs installed for data access and redundancy
  • Networked capacity of over 100 seats.
  • 200% power back up
  • 24/7 secured state-of-art access control systems
  • Fire alarm and prevention system
  • Dedicated training infrastructure

Training:

In any skill development process, Practice makes perfect. At ITH we believe in the value of practice as a means of reducing human error- in claims processing, and in applying the relevant billing rules on each account. We have a variety of training programs catering to various kinds of roles such as Demographic entry, Coding, Charge entry, Transmission, Cash posting, Denial Analysis, AR Calling, Project transition, Project management and Team management.

Process & Delivery

Patient Demographics and Charge Entry:

Our Medical Billing Charge Entry Service gets your Claims and Demographics entered in your billing system rapidly and accurately. Through the creative combination of advanced technology and qualified and experienced billing professionals, can get the claims sent to payers faster with 100% quality. A completely seamless solution that minimizes processing while utilizing your guidelines and billing software.

Client Requirement Analysis Study:

This process commences once a Client approved to conduct process study and to submit a presentation on the benefits of business process outsourcing. The study will determine the specialties covered, required cycle time, type of files, type of reports and formats required.

Transfer of Files from Client:

Clients send scanned copies in ".tif" format of patient registration sheet, super bill, and insurance card copies to ITH through FTP site.

Downloading and Allocation of Files:

The files received from Clients are downloaded by Medical Billing Team and assigned to dedicated Demographic and Charge Entry Team.

Patient Demographic Entry:

Once the downloaded files are assigned to designated team, the Demographic Team starts entering the patient's details that include patient's name, Date of birth, address, social security number, Employer, Insurance , and guarantor details.

Charge Entry:

After entering demographics the Charge Entry Team inputs all charges which are given in the super bill with the appropriate procedures, diagnosis and modifiers into the billing system.

Claim Submission:

Upon completion of Charge Entry process, a claim is electronically submitted from the Client's billing system to the insurance company. For paper claims, CMS 1500 or CMS 1450 forms are filed, scanned, and uploaded to ITH's FTP site that is forwarded to the Client to be mailed.

Cash posting:

Experienced billing professional post payments from EOBs, Charge Slips and other documents. They post payments to the patient account number, billed amount, adjusted amount, paid amount, Write-offs, co-insurance, denials , adjustments and Correspondence processing.

Analysis

EOB Follow-up:

When partial payment is made, analysis is conducted and corrective action and follow-up is taken.

Denial Analysis:

Analysis is conducted on EOB and claims to take appropriate action to recover the amount.
 

Medical Transcription

In a borderless world and through the advancement of technology and communication, global community is able to leverage competencies available beyond its own geographical borders. ITH, located in Chennai, India, is an ideal provider of competitive, efficient and effective healthcare BPO services.

Services

ITH enables the Physicians to focus on patients care and management leaving the administrative and non-core areas to ITH. ITH has developed an integrated network of transcription resources using advanced technology capable of providing fast turnaround time to meet the clients needs. ITH has the capability to optimize an efficient and effective system to meet the needs of clients that requires large, high volume transcription. The system is flexible such that not only it can accommodate the transcription needs of clients with single department but also clients with multi-facility health systems, multiple departments, large clinics or entire healthcare organization.

Using advanced technology and secured network, ITH is committed to provide timely and accurate medical transcription services. ITH is able to receive transcription data and transmit the finished products to wherever the clients wish them to be sent.

Reports

The following are some of the reports that the system provides:

  • Letters
  • Discharge Summary
  • Operative Note
  • SOAP Note
  • Progress Note
  • Initial Evaluation and Management
  • Independent Medical Evaluation
  • Telephone Consultation
  • Consultation
  • History and Physical Notes
  • Psychiatric

Features

All ITH systems comply with security guidelines prescribed in the four HIPAA categories specific to Transcription related organizations Physical Safeguards, Security Services, Security Mechanisms and Administrative Procedures. Using only secure streaming over the Internet, ITH system is able to:

  • Receive and handle voice files (dictation)
  • Deliver Transcription (finished products)

Quality Assurance

ITH transcription system ensures clients that it exceed the 98% accuracy industry benchmark. The finished products should not require any further intervention as the process demand a multiple quality assurance steps:

  • Transcription by experienced production team
  • Multiple level of 100% review of voice data and documents
  • Proofreading team to eliminate English and formatting errors
  • Quality Assurance team that maintain standards and quality

Fast Turnaround

ITH is committed to satisfy the needs of fast turnaround time that most clients demand. To ensure timely delivery of transcripts, ITH operates 24 hours, 7 days a week, 365 days a year. By having a systematic manning system, ITH is able to ensure turnaround time of not more than 24 hours. For emergency cases, transcripts can be made available within 4 hours of receipt of data.

Delivery Method

All transcripts are delivered to clients via email or secure web server and copies can be made available to referring physicians, if required.