Industries: Healthcare Industry
Flowz’s healthcare industry services are affordable and 100% HIPAA compliant. We offer you a streamlined workflow, enhanced staff productivity, and 40 hours of weekly support for specialties like cardiology, internal medicine, oncology, etc.
Healthcare Services
Additional Details
Revenue Cycle Management (RCM)
Revenue cycle management (RCM) is a process that manages claims processing, payment, and revenue generation. It entails using technology to keep track of the claims process at every stage, so that the healthcare provider doing the billing can follow the process, address any issues, and allow a steady stream of revenue.
Payments that are denied can mean your company could lose up to 90% in revenue. Having RCM in place ensures that payments are made.
RCM encompasses everything from determining patient insurance eligibility, collecting co-pays to properly code claims using ICD-10. Time management and efficiency play pivotal roles in RCM, and a physician’s or hospital’s choice of an EMR will largely depend on how their RCM is implemented.
Durable Medical Equipment (DME) and Home Medical Equipment (HME) services
In healthcare, there are many plans such as dental, prescription drug, in-patient services, wheelchair, and durable medical equipment services. At Flowz, we offer stand-alone services that can enable you to pick and choose the services you need. Our team is also proficient in billing and management systems in healthcare.
One such service is the Durable Medical Equipment (DME) whereby we provide complete back-office automation services to the DME & HME providers who supply products and accessories to patients suffering from sleep apnoea. Patients suffering from this ailment are authorised to get supplies of products such as CPAP, nebulizers, kidney machines or BIPAP machines and the payments can be claimed using government owned insurance companies or privately owned ones.
The healthcare industry is continually evolving and as such DME’s and HME’s have become more popular. As a result, it has become more challenging for organizations to track and maintain proper bills of accounts. Outsourcing these services to us ensures that there is ongoing profitability in your organisation and gives you better control of your medical billing processes. Flowz can also assist your clients with claims compliance, entry and reducing the turnaround time for reimbursement of claims.
We handle DME Billing in two parts:
1. In-take which consists of verification of patients’ documents such as demography, insurance, and policy details before any service is rendered.
2. Accounts Receivable (AR) whereby we ensure that the money owed for services rendered to patients is paid timeously.
Here are some of the services we offer:
- Patient calling
- Patient registration and charge posting
- Eligibility verification
- Claim submission and clearing house denials
- Payment posting and payment reconciliation
- Denials and account receivable management
- Patient calling or patient scheduling and appointment management services
- Scheduling appointments through the provider’s online portal results in a smooth pre-registration process
- Collection of patient’s demographics for eligibility and prior authorization requirements
- Fixing the schedule based on the provider’s availability
- Direct communication with physicians and patients through the messaging system
- Informing patients about the appointment and seeking confirmation
- Sending automated reminders to the patient and provider
Patient Registration or Demographic Entry
We validate and update the following patient information in the practice management system:
- Legal name, gender, address, phone numbers (work/home/mobile)
- Social security numbers for identification
- Health insurance information and policy details
- Medicaid or Medicare policy
- Contact information for the person who is responsible for payments.
- Special requirements (interpreter, stretcher access, etc.)
Eligibility and benefits of the verification services
- Workflows received through the patient scheduling system, EDI, Fax, emails, and FTP files.
- Accurate verification of primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible, and co-insurance and benefits information.
- Efficient connection with the payer using the best possible channel (phone or web)
Prompt identification and resolution of missing or invalid data - Upgrade eligibility verification processes with our proprietary RPA tools
Here are some of the steps we undertake prior to authorization
- We prepare and submit paperwork to the payer.
- Next, we consistently follow-up on the submitted authorization requests.
- We will immediately notify you of any issues with the authorization requests.
Denials Management and Account Receivable (AR) Services
Each patient is unique when it comes to the healthcare, they receive so each denied claim is also unique. Flowz uses a systematic, hands-on approach and each claim is resolved quickly, while adhering to a strict systematic approach and defined best practices. This ensures that the collections are efficiently handled.
AR is an important step in the revenue cycle. At Flowz we leverage on our tried and tested best practices and have a proven process to collect payments thus reducing any backlogs. This results in faster collection of money. Each claim is analysed and researched by an Access Healthcare associate to determine the best course of action.
Our associates:
- Prioritize claims based on payer, amount, age of bill, or other business rules to ensure maximum benefits.
- Improve the healthcare practice by preventing future denials and offer suggestions for improving your processes.
BENEFITS OF PARTNERING WITH US
- We are HIPAA compliant which boosts the revenue cycles.
- Zero set up cost.
- We help your business to improve the cash flow cycle.
- We offer quick support to ensure a faster turnaround time.
- We improve your revenue collection by continually following up on your bills and records.
- We help you save more than 60% on operating costs
- We ensure that you have a risk free business support service by having stringent information security policies and practices in place.
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