Post on 11-May-2015
description
Talisman Solutions
Talisman Solutions IncIntelligent Solutions Excellent Results
RCM / Medical Billing Services
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Agenda
Talisman Introduction
Common Pain-points
Talisman Advantages
RCM (Revenue Cycle Management) Activities
Talisman RCM Offerings
Talisman RCM Process Flow
Information exchange options
Talisman Quality Assurance Process
Security & HIPAA Compliance
Coding Services/Process
Software Product Offerings
Q & A
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Company Introduction
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About Us
Utilizing years of experience and unique blend of healthcare business, process, and IT technical skills our team has proven track record of implementing intelligent solutions and delivering excellent results at minimal cost. We specialize in RCM, Medical Billing, Medical Transcription, EMR, PHR, Custom Software development, product implementation, and other services.
Core Values Outside-In approach – Customer Focus.
Quality – Established Reputation for Quality.
Security and Safety of Data.
Minimal Operation Costs – Save every penny.
Speed and Flexibility - get the job done.
Kaizen – Continuous Improvement to Maximize Productivity and Quality.
Learning Organization – Every employee continuously learns and grows.
Fun loving work culture
Mission Statement To proactively enable clients to focus more on their core activities by successfully
owning up business activities on their behalf in an efficient, effective and persistent way and bringing value to the relationship by successfully leveraging our domain and technical expertise.
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History & Identification
History Talisman Solutions has been serving clients since 2004 and has grown consistently
because of our excellent customer service, quality delivery, and reasonable cost. We work with numerous organizations in various geographic across North America, Europe, and Asia.
Identification & Information Company Name: Talisman Solutions, Inc
Address: 2000 Town Center, Ste 1900, Southfield, MI 48075
Entity Organization: Corporation
State Of Incorporation: Michigan
Name Changed: Never
Accreditation Better Business Bureau
American Medical Billing Association
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Common Pain-Points
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Business Issues/Challenges Changing regulatory environment
Government policies
Legal and Compliance issues
Profitability How to lower fixed and variable costs
How to improve cash flow
How to minimize bad debt
Inefficiencies Lot of paper documents
Inexperienced/Untrained staff
Managing assets, equipment, and inventory
Stagnant Revenue How to increase patient base
Stay ahead of competition
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Business Issues/Challenges Workforce
How to attract and retain best talent
Man power issues/work force shortage
Resource waste
Optimizing resource utilization
Management Lack of transparency
Lack of visibility on the Hospital/Clinic progress
Legal Obligations Paying fines for keeping expired medicines un-knowingly
Emergency preparedness
Patient Care Quality of patient care
Patient records and history
Cleanliness in the practice
Managing Referrals
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Talisman Advantage
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Talisman Advantages Complete Healthcare Solutions Provider
Healthcare Products – EMR, HIS, etc Healthcare Services – billing, transcription etc.
Best in Industry collection Rates Aggressive - Go after every penny All claims filed with payers within 24 hours
Best value in industry Very reasonable cost for quality of service No fixed cost; you only pay for the service if you use it
Expertise Excellent knowledge of various insurance billing processes Well established quality assurance process Experienced, educated, and Knowledgeable workforce Continuous stress on trainings and skills upgrades
Exceptional service Dedicated account manager assigned to each account Support available through toll free phone, email, chat, etc
Cost
Efficiency Quality
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Talisman Advantages (Cont…) Secure & HIPPA Compliant
100% HIPPA compliant. Free secured email & Secured FTP account
Knowledge Sharing with Client Free consultation and education sessions for client’s staff
Zero cost Liabilities No employee costs – no healthcare, training, vacation, pension, etc No software or hardware costs
Free Trial & Non-binding agreement See for yourself where we stand on our quality and cost commitment. You can stop the service at any time
Easy Integration Expertise in integrating with any in-house EMR or any other system.
Flexibility Pick & choose services to suit your practice and budget We can either work with your software or our own
Scalable Solution Handle volume surges and seasonal changes efficiently
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Facts & Figures
Customer Satisfaction
Collection Rates
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Facts & Figures (Cont…)
Additional Services
Kay Differentiators
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Billing / Revenue Cycle Management Services
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RCM Activities
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Talisman RCM Offerings
Front End Services Appointment scheduling and confirmations Patient Demographic Entry Insurance Detail Entry Insurance Verification Pre certification/authorization
Billing Services Charge Posting QR and filing claims with payers Payment Posting and Adjustments Claim re-filing if required Filing secondary claims Appeals Accounts Reconciliation
Payer AR Services AR follow-up Denial Management
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Talisman RCM Offerings (Cont…)Medical Coding Services
Assigning CPT-4, CDT, HCPCS, ICD-9, LCD/NDC as and when required
Patient Billing & Collections Patient Statements/Notices
Patient follow-ups & Collections
Reports Standard and Custom reports provided bi-weekly, monthly, and annual basis
Insurance Aging, Patient Ledger, Revenue analysis, AR log, and many others
Separate analysis reports for each provider in facility
Healthcare Software Electronic Medical Records, Electronic Patient Records
Patient Health Records
Hospital Management System
Other Services Medical Transcription Services
Healthcare IT Consultancy and Implementation
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PATIENTS
INSURANCE COMPANIES
All starts & ends with thehospitals &
the physicians
TSI MEDICAL BILLING CENTRE
Bank TSI Collection Service Centre
TSI Collection Service Centre
Electronic Claims
Paper ClaimsMisc.
Correspondence
Electronic Claims
EOB & Payments
Statements
Payment & Billing Enquiries
Misc. Correspondence
Insurance EOB s
Patient Information, charges, payments and denials
Patient & Insurance payments deposits
Patient Visits
Patient Payments
Patient Payments
Delinquent Accounts
Additional Collection Attempts
Talisman RCM Process Flow
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Information Exchange OptionsNumerous information exchange options are available to clients: Remote Login onto facility network
No transfer required; our team logs into client network and words same as on-site employee
On-Site representative Our representative is sitting with client in their location
Entry into HMS, EMR, EHR, PHR, or any other system Client enters information in their system, we log into the system and access the information
ourselves
Faxing Documents (Toll Free fax number) Client faxes the documents to our toll-free electronic fax system
Automated transfer using our Secured FTP server Information is automatically transferred from client machine to our server.
Secured Email on computer We provide HIPAA compliant secured email account to all our clients, which is used to
communicate any PHI/confidential information
Custom Online system We create online forms customized to your needs
paper records US mail – we do the data entry into the system Old paper records can be sent to our office and our staff would enter those in the system.
Automated Scanner
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Talisman Quality Assurance ProcessTalisman has well-established, seasoned, and repeatable quality control process that
ensures excellent quality, high productivity, and maximum collection rates for clients. Some steps followed as part of QR process are:
Review all claims before submission To minimize error rates and denials, the team leader reviews all claims before submission.
Claims Audit Auditor/Manager randomly audits the claims to verify accuracy and compliance.
Strict Quality Control standards Our team has assimilated years of lessons learned into the standards booklet.
Every employee is regularly trained on the quality standards
Review log and knowledge database Issues and denials are regularly triaged and the reasons captured in our knowledge database.
We leverage this database to track and monitor trends and provide remittance advice. We also take proactive actions to eliminate the problems and maximize collections.
Kaizen (Continuous Improvement) Sessions In order to continually improve, a monthly brainstorming session is conducted with clients.
Methodology group captures ideas, issues, suggestions from the meeting and improve the existing processes. Trend analysis, recent changes, newsletters etc are also shared with the team.
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Security & HIPAA Compliance Talisman Solutions takes painstaking measures to protect all information related to
patients. Our internal procedures for privacy and security meet and exceed all HIPAA regulations related to Electronic Transmission of Patient Information.
Physical Security: Access to our facilities is controlled by key entry only. Only authorized staff that is fully
aware and trained in the HIPAA Privacy requirements will be issued access
Information Security: We use an ICSA certified firewall and filter on incoming ports allowing only secured
FTP and management ports for administrative access into our system. Our network also performs Network Address Translation (NAT) and addresses cannot be routed without traversing the firewall.
When our FTP Server is accessed with SSL FTP Client and all files are encrypted while being sent across the internet. So, anyone intercepting any data while it is being transferred from our server to your computer could not interpret or decode this data.
To access any data from our FTP Server, a valid user name and password is required. Secured email is used for communication Access to our network is limited by auto-log off, ID/password protection, password
protected screen savers, and a security-enabled OS (WinNT) We are not responsible for the security of files (documents or sound files) that are
transferred to or from our server.
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Coding Services TSI offers high quality coding services to Hospitals and Healthcare Providers. Our
team is comprised of experienced Certified Professional Coders (CPCs) accredited by the American Academy of Professional Coders (AAPC). They have proficiency in the following code sets and usage guidelines; CPT-4, HCPCS, ICD-9-CM, CDT, LCD/NDC and CCI EDITS.
TSI ensures the quality of our coders by an effective auditing and monitoring mechanism. Our coders work in accordance with updated standards and methodologies laid down by CMS, Medicare contractors, AMA, medical societies, and federal organizations.
We conduct detailed procedural processes to assess quality at every stage. We use the most up to date books and software like CPT-4, ICD-9, HCPCS, CCI edit
to keep in touch with the constant changes in the coding world.
We have dedicated professionals who work under the AHIMA rules.
Our coding staff have received extensive training under coding experts in the U.S. Certified coders monitor their work regularly and external coding and compliance experts periodically audit the department.
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Coding process
Talisman has well-established coding process that ensures accurate coding for clients.
Talisman accesses Patient documents / files / reports etc.
Certified coder verifies and validates the documents, split them into batches and review them for completeness, quality and readability.
Diagnosis, Procedure Codes and Modifiers are assigned as per client descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code).
Diligent quality control team audits the coded charge sheets and processes it further for charge entry and cash posting
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Talisman Software Product Offerings
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Product Offerings
iHelix products provide an end-to-end solution
Central repository allows for integrated solution
Better data and information integrity
Higher user productivity
Effective security, governance & compliance
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Product Highlights Flexible subscription models
Software-as-a-Service model
Licensed model
Support for standards HL-7, DICOM, HIPAA, CPT, ICD9
Anywhere Access - Web based
Highly Configurable Solution
Multi-language support
Analytics/Management Reports e.g. key risk indicators
Rules & Workflow Engines
Security Integrated Compliance / Audit / Security
OTP(One time password ); Role Based / Account level security
Real time reporting.
Built bottom-up with Latest technologies.
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Popular features Medical record identification for facility
Ward Management
Procurement
OPD Services
Converting a patient from OP to IP
Discharge Summary
Drug Indents
Medical record based on Date selection
Off-load Analysis/Mobile clinics
SMS integration
e-mail integration
Bar Code/RFID Integration
Mobile Devices support
Text Editor ( Consent Forms)
Back up/Archiving
Alerts for prescription/drug reactions etc.
Change Log at system/terminal level
Resource assignment
Discharge Summary
Insurance Claims
Tariff Rules
Change Tariff
Picture upload for specific specialty
Image editor
Treatment Plans
Lab Templates
Package Rule/Package Assignment to the patient
Referral doctors accessing the medical records
Medical Certification Issues
Offline Processing
Lab Integration with equipment
Bio-Metric Integration
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Q & A
For Questions: (888)-617-9894 (Call); (866)-580-9174 (Fax)
info@talismansolutions.com
www.talismansolutions.com
2000 Town Center, Ste 1900, Southfield, MI 48075