1. HOW DO YOU GET THE DATA TO PROCESS?   • The super bills and EOB’s are scanned using a scanner and converted to image files. These image files are placed on a FTP site for the service provider to download, print and process. • Alternatively the documents never leave the clients location and we get only the image file for processing.

2. WHAT KIND OF CONNECTIVITY IS REQUIRED AT THE SERVICE PROVIDER END?   We have the best of the communications technology to deliver world-class output. Our offices are connected with the US clients through secured VPNs (virtual Private Networks), which provides access to our staff to work on the billing system in our customer’s office. In the cases of clients for whom we provide end-to-end medical billing services, we also utilize the IPLC (International Private Leased Circuit) which provides us the connectivity to US-based telephone companies enabling us to make calls to Insurance Companies and also to provide toll-free 1-800 numbers to receive patient inquiries.

3. HOW DO YOU GET THE EOB’S AND CHECKS TO POST?   EOB’s and check copies are scanned in the same way as the super bills. We receive the copies of the checks with the EOB’s and ensure that the totals of checks and EOBs tie up for balancing purposes. This data is also logged to reconcile with the bank deposits.

4. HOW DO I KNOW THAT YOU RECEIVED ALL THE DATA?   When the documents are scanned, the computer assigns a file number to each file. This is entered into a ‘CONTROL LOG’ which will contain the file number and the number of pages that were scanned. The ‘CONTROL LOG’ is then scanned and printed and we check off each of the files which were printed. In the case of any file which is not clear in scanning or in case the pages are not adding up correctly, we will e-mail the client seeking clarification for the variation.

5. WHAT KIND OF SERVICES IN MEDICAL BILLING DO YOU PROVIDE?   We offer end-to-end solutions for the Billing companies and Physician practices. By choosing these services you will be able to concentrate on your core business and leave the billing hassles to us. The various services we provide include: • Claims data entry: We have the data processed and inputted into the system within 24 to 48 hours of receipt for normal workflow. This data is audited for accuracy to ensure that the claims submitted are clean and in compliance with rules to ensure optimal and faster reimbursement. • Claims generation and submission (electronic and paper): Most of our claims are submitted electronically to avail the benefit of faster payment. We use clearinghouses other direct submission modes. Paper claims with attachments (primary and secondary) are printed and dispatched for postage in US on frequent basis if such a service is chosen by the customer. This takes about 3 business days to reach Clients office. • Payment posting: The copies of checks and Eob’s are scanned and received by Service provider for Payment posting. All payment posting is completed with 24 to 48 hours of receipt. At the end of the day, the balancing of posted to deposit is done and also included for end of month balancing of receipts. • Underpaid / unpaid claims identification and appeal, follow up Denials / Under-paid claims are identified at the time of payment posting and also by scrutiny of the regular mail. All identified items are researched for further resolution by calling up insurance companies or by taking appropriate action. All the denied claims are acted within 3 - 4 business days of receipt • Account receivables analysis and management: We have experienced analysts who research the unpaid claims by insurance company to identify potential problems and take appropriate action for resolution. Also, the payment patterns of the major insurance companies are identified and all unpaid claims over the benchmark days are set up as work order for our call center agents. They then call up the Insurance companies and check on the claim status. It is a policy to check the claim status on all claims that are unpaid and this process results in identification of the problems early and in the increase in the collections by 15-20%. This also reduces the reimbursement cycle. • Financial reporting including customized reports as and when required: We have a dedicated MIS team who complete the financial and other practice reports on agreed timelines. Also the client required reports, which occur during the month, are met on a timely basis. The general monthly reporting would include (as per clients protocols) o  Daily recap summary o Patient type/Financial class activity o Doctor wise financial summary o Service analysis by doctor, location, department etc. o Aged receivables report by Financial class o Any other report requested by the client as part of month end reporting • Patient billing and follow-up: We discuss with the client and evolve a policy on balance billing the patient. Patient billing is carried out as per the policy for frequency, value and number of bills before it is sent out for collections. Follow-up with the patients depends on the policies set forth by the clients, since they may want to handle all patient interactions. • Handling patient enquires: We have diligent and courteous staff members to handle sensitive patient enquiries and to provide them with any clarifications that they may require on the bills sent. • Provider enrollment assistance: Our checks the provider details with the insurance companies on a regular basis to ensure that the details of the provider are correctly reflected. We assist the practice in submission of application forms and track the processing on a weekly basis to ensure that the provider enrollment is done on time and accurately.

6. HOW DO YOU KNOW THE BILLING RULES?   At the time of the Account Transition, we write up a Transition manual with the client and then proceed to write an operational manual, which lays out the policies and procedures for:   • Charge entry • Payment posting • Batching system • Month-end reconciliation • Refund policies • Patient billing policies etc.   Also, we have a team to verify the manuals/ websites /newsletters for any changes in billing rules. We also call up the Insurance companies to prepare a checklist for the way they like to see a claim. The team also reviews all the materials / documents received out of subscriptions to insurance updates by emails from the industry forums for identification of change in processing rules.

7. HOW DO I KNOW WHAT CLAIMS WERE SENT OUT?   The transmission team which is responsible for the claim prepares a log of each transmission and they cross-verify the claim with the confirmation reports received from the insurance carriers. Every week, a summary log is prepared to list the transmissions by payer and the number of claims that were rejected in edits.

8. HOW DO YOU HANDLE REJECTED CLAIMS DURING TRANSMISSION?   The transmission team logs all the rejections and provides the claims to the operations team to correct before re-transmission. E-mail for clarification is sent to the clients if it requires their assistance.

9. WHAT ARE THE QUALIFICATIONS AND EXPERIENCE PROFILE OF YOUR STAFF?   Completing their Graduation/ Bachelors Degree is a minimum qualification for all employees. Account managers/analysts are also further professionally qualified. We have a very low attrition rate. The staff is paid fair market rates and enjoys the working atmosphere. The average experience of the staff in Medical billing is 3-5 years.

10. HOW LONG IS THE TRAINING PERIOD FOR NEW RECRUITS?   The trainees undergo a classroom training session for understanding the basics of medical billing, and then undergo relevant software training. After this they are deputed to work with a senior operator to understand the work flow and the processing routines. It takes 4-6 weeks for the staff to accept live assignments. In the case of Call center agents, it takes about 6-8 weeks before they are allowed to handle independent assignments. Apart from the product knowledge, their training also covers soft skills like American accent, telephone skills etc.

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