HEALTH CARE OUTSOURCINGSERVICES

Technomine – An Introduction Founded in 2008, Technomine is one of the leading ISO 9001:2008 certified

Outsourcing Company, serving clients for USA, UK and other European and Middle East Countries. We help our clients in staying focused on their core business while we take care of the entire non-core activities of their organization. Our commitment towards quality and consistent performance has helped us create value for our clients and become an integral part of their business process. 

Technomine is a ONE STOP SOLUTION for outsourcing business. We primarily service the Health care domain for Medical Billing/Coding, Revenue Cycle Management, Claims & A/R Management.

Technomine also renders services for Permanent and Temporary placements of Doctors, Nurses and other Health Care Professionals.

Accounting and Finance process outsourcing, Recruitment for varied industries inclusive of construction, Energy, Contracting, Engineering & Manufacturing and IT. We also provide state of art IT based enterprise solutions to our clients.

With almost a decade of experience and excellence in services, we have successfully emerged a trusted partner to our clients. 

Health Care DomainTechnomine is committed to provide professional and State of Art Medical Billing & Coding and Revenue Management Services to Hospitals, Clinics and other healthcare providers to navigate and succeed in an increasingly complex reimbursement environment.

Since inception, Technomine has grown as a company with an integrated portfolio of leading information technology, process, and domain expertise solutions to address the wide array of threats to the financial health of medical practioners, clinics, hospitals, and other essential providers.

Our approach to Medical Billing/Coding ,Revenue Cycle Management, and Reimbursement is comprehensive, practical and innovative.

We leverage people, processes, information technology, and services to maximize the financial and operational performance, and ultimately the clinical performance, of our clients.

We ensure you assistance in your odds……..

To Help You be YOURSELF……..

Our Services

Medical Billing ServicesMedical Coding ServicesMedical Claims ServicesRevenue Cycle ManagementDenials & A/R Management

Business ModelBusiness Model

Value Chain

Medical Billing Services

The Revenue Cycle

Low level of collections and large accounts receivable backlogs

Retention and management of billing staff

Lack of qualified personnel and billing resources

Increasing need for IT capital expenditures

Difficulty keeping up with ever-changing claims processing procedures

Lack of follow through on low value claims and with insurance companies on Credentials, payment, etc.

Rising costs of administration and processing services

Distraction from core business objectives

Challenges

Claim Lifecycle - Overview

Revenue Cycle Management

TQ Extracts Appointment Schedule 4 days in Prior to Svc. Date from client’s PMS

Verify Patient’s Ins. coverage & Demographic info with Insurance

Pat. A/c ‘s with issues are mapped with appropriate status code

Eligibility Reports forwarded to corresponding site location

Front desk @ site location rectifies the invalid (or) missing patient. A/c information.

Eligibility Verification

Client scans super bills and upload the scanned files on to a secured server located at client’s office.

Trans-quest downloads the scanned Super-bills and distribute the files for Coding

Our CPC certified coders analyze each super-bill and code as per the guidelines set by CMS and AMA

The coded Super-bills are then examined for any possible errors by a well experienced CPC certified coder

Audited Super-bills are sent to the Charge Entry team to create claims in Client’s PMS system

Medical Coding

Scanned patient’s demographics and the coded Super-bills are sent to Entry team to create claims in Client’s PMS system

Each patient’s scanned record is analyzed and determined if it is a New patient or an Established patient

If it is a New patient, then create an account in Client’s PMS system. And update the patient’s A/c if it is an Established patient.

Create claims in Client’s PMS system based on coded Super-bills

Thorough audit of claims data to ensure optimal quality levels prior to claim submission

Patient Registration and Charge Entry

Primary & Medicare Secondary Electronic:

Primary & Secondary Medicare electronic claims are submitted directly to Medicare connecting through the Client’s PMS system from the central billing location.

Care-First and various other commercial Insurance claims are submitted through a clearing house (Emdeon/Proxy Med).

EDI claim acknowledgement reports are retrieved and analyzed to trace any rejected claims with in 24 hours from transmission.

All rejected claims are resolved by taking corrective actions and re-submitted on the same day.

Paper Claims:

Paper claims are queued on the client’s practice management system so that they are printed on a CMS 1500 form at the client’s office and mailed to various insurance companies accordingly.

Claim Process Management

Scanned EOB’s are downloaded from Client’s office at Trans-quest and distributed among the Payment posting team to further process those batches

Payment team will create a batch and set the target value to be posted in Client’s PMS system

Analyze each EOB and post payments, adjustments or flag denials in Client’s PMS system as per the scanned EOB files

Batch log is printed from Client’s PMS system to reconcile the batch posted and audit transactions by the posting team

Thorough audit by experienced payment team to ensure optimal quality levels in transaction posting

Payment Posting and Reconciliation

The AR Analyst receives the work order from the Cash posting department on all the Unpaid / Part paid claims

After analyzing the Unpaid / Part paid claims report, the Analyst identifies the claims that need to be further researched allocate the work order to our AR team

A weekly Insurance receivable summary and detailed report are generated from the Client’s PMS system by our Analyst team for claims that are 20 days past billed date

Work orders are then distributed by the Analyst team based on the Age of the Ins. AR and Filing / Appeal limits of outstanding claims

The A/R Analyst takes final action on the claims worked by our AR team and forward reports to client if additional information is needed to resolve those balances

Accounts Receivable Management

Weekly Financial Summary Report

Net Coll% & A/R Outstanding Summary Report

Comparison Reports & Benchmarking

Accounts Receivable - Detailed Report

A/R Summary – (Insurance wise) - Analysis Report

Insurance Claim Rejection Reports -Detailed & Summary

Denial Summary Analysis Report

Patient Outstanding Balance Report – 90+ AR Days

Insurance Eligibility Verification Report

Pre-certification Verification Report

Technomine Enterprise Reporting

Daily charges are posted in to client’s Billing system with in 18 hrs of receipt

Claims are submitted on the same day the charges are posted in PMS system.

Report to client on any unresolved EDI claim rejections pertaining provider and patient registration issues.

Same day payment posting & reconciliation in to client’s Billing system with in 18 - 24hrs.

Increase the probability of payment through timely follow-up on accounts having possibilities for delay in payments and take corrective actions to resolve these claims.

Delivery Model that not only accelerates your cash flow, but also reduce Days in A/R and also improve Collection Ratio.

Prompt resolution of EDI claim rejections with in 24 hrs from claims transmission date and resubmit corrected claims.

Technomine Delivery Model

Advantages

48 hour turn around time for claim submissions and cash postings Prompt follow up on every account before 30 days aging to reduce DenialsDedicated account manager and detailed monthly MIS reportingUp to 40% reduction in operating costs and up to 20% increase in revenueFaster collection cycle with Greater than 95% accuracy

Decreased accounts receivable days & financial delays

Improved cash flow owing to experienced billing resources

Highest level of document and data integrity

Process to ensure HIPAA Compliance

Employees sign Confidentiality Agreements

Access to information only on a “Need to Know” basis

Excellent Domain Expertise

Certification from AAPC

Active Member of HBMA & MTIA and active participant of MGMA

Leadership Development Programs

Continuous Training and Development

Leverages

Streamline your Operations and WorkflowCash flow increaseSave on the high cost of equipment and software as rapidly changing technology translates into extra expensesReduce staff size and employees expensesEliminate sick pay, vacation pay, insurance benefits, workers compensation, etc.Eliminate training costsReduce call volumeFocus on patient care instead of billingNo cash-flow interruptions due to staff turnoverReduce costsEliminate “non-medical” business office spaceReduce record storage spaceReceive detailed reportsEliminate provider/patient payment discussion

What Difference We Create…..

Human Resources

Quality Management , AuditsAnd Reporting

Infrastructure &Technology

Excellence, Training,Process andRegulatory Compliance

Management Experts

Our Synergy

Process Optimization and Business Intelligence

INFRASTRUCTURE

Technomine has a very well developed infrastructure. We leave no stone unturned and below are some salient features of our infrastructure which reflects our commitment to provide a seamless quality of service and provide a healthy working environment for our employees.•6000 sq. ft. of operational area•Certified as a zone 4 earthquake resistant office•Fire alarm and safety across the entire office•24 X 7 power supply with back up UPS and generators•100 Mbps intelligent network powered by Nortel Switch•Fiber optic based leased line for high speed internet connection•Recreation facilities•Separate dining area for the employees

SECURITY AND QUALITY

Technomine is an ISO 9001:2008 certified company. We implement the latest and the best practice followed in the industry to provide a high quality of service and protect the interests of our clients.•Secure VPN protected by Sonic WALL TZ 210 firewall•Digital ID card for all employees to access the office premises•Restriction on the usage of personal devices (i.e. cell phones, PDAs, Tablets etc.) in the building•Restricted access of employees to servers•Separate area for visitors•Limited access of the internet to prevent unauthorized usage•Centrally managed anti-virus for data protection and theft•Passwords and access control across the organization•SSL protection of servers•File encryption to prevent data theft•Non Disclosure Agreement signed by every employee•Destruction or returning of all data (digital or physical) to the client upon request

Technomine Quality Monitoring Services

Technomine offers a complete end to end solution to help you develop the contact center and its quality monitoring service model for your organization

Quality Assurance is a must for measuring efficiency and effectiveness of business processes. We at Technomine assist companies in identifying opportunities and deriving actions to improve their processes, sales conversion and customer satisfaction.

We also provide intelligent data with the help of our Contact Center Quality Monitoring program that produces insight which will drive business improvements.

An effective quality assurance model and plan help us deliver better sales results, improve customer experience and also ensure all regulatory and compliance requirements defined by the clients are met consistently.

360 Degree Quality monitoring Services for Contact Centers and Captives (Quality monitoring of Inbound/Outbound interaction) Voice Web Interaction

Transactional Monitoring & Teams compliance to GDS/CRM, sales, and service policies

Customer Service Improvisation

Customer Experience Survey scrub

Customized Agent level Coaching and Feedbacks

Market intelligence based on chats, calls and emails from customers

Process compliance audits

Sales Verification & Sentiment Analysis

TQMS online platform for quality monitoring and data analytics to ensure Real time Reports

Socially Enabled Center

Technomine Quality Monitoring Services

QC •Interactions will be monitored by QCs•Direct feedback of each interaction will be sent to particular agent

QA •Weekly interactions will be checked and analyzed by QA for the agents and team •Weekly/monthly generalized feedback will be sent to clients for the teams and agents

ATA •Sample Interactions checked by QCs and QAs will be checked by ATAs to maintain QC’s Quality •All the analytical reports and disputes will be rechecked by ATAs and then only sent to Quality Leaders

Quality Leaders •All the reports and analytics will be finally checked by Quality Leaders •Then Quality Leaders will send those reports, QBR and analytics to the end Clients

Multi Layer QMS Integration

Quality Assurance and Six Sigma• Create possible

solutions and selection of solution: Designing of the quality parameter, scorecard , SOPs, and policies

• Develop and pilot plans: Training agents according to that SOPs and policies so that they follow it properly

• Collection of data: Check and gather data from the outcome of implementation, whether it is helping clients to improve their customer satisfaction level

• Evaluate and Review: Take the outcomes from the data and implement the positive one and work on the negative one in next planning

Plan Do

CheckAct

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1 Deep expertise and experience in serving the healthcare industry

Passion for achieving the highest level of quality

Broad understanding of clients’ long and short term goals

Focus on building partner relationships

Emphasis on ingenuity to achieve maximum cost savings

Documented ability to deliver on time and according to specifications

Differentiator

Our Global Memberships

LET’S PARTNER……………………..