We minimize the burden of the hospital in insurance recovery by providing a platform where entire insurance process can be managed starting from bill docket preparation, claim submission, follow up, query management, payment management, deduction management, deduction analysis and reconciliation of all payments received.
In general terms, Revenue Cycle Management or RCM refers to the entire medical billing processes which track record of the patient from beginning to end. The episodes take control of registration formalities and appointment scheduling to the final payment of a balance. It may further include Data Capturing, entering, and editing the information needed to create a medical billing claim (to an insurance company or payer) till the collection and deduction analysis of claims are done. The entire process of Hospital Claim Recovery facilitates managing the administrative and clinical functions associated with claims processing, payment, and revenue generation. This further includes "demographic" information about the patient including insurance coverage details and "charge" information: a combination of CPT and ICD-10 codes. This financial process is the key basis that forms a link between the hospitals and patients. Revenue Cycle Management is the strategy that healthcare organizations use in order to settle the claims & the bills.
Basically, the process begins when a patient visits a doctor to seek advice and medical services. It ends when all claims and patient payments have been collected and reconciled. The whole process of Revenue Cycle Management provides a groundwork which makes it easy for claims to be billed and collected in the most effective and efficient manner.
What is Healthcare Accreditation?
It is public recognition of the achievement of accreditation standards by a healthcare organization, demonstrated through an independent external peer assessment of that organization's level of performance in relation to the standards. Hospital accreditation is one of the component in the maintenance of patient safety. In totality, accreditation is about standard-setting, analysis, counselling and self-improvement dimensions to the process in addition to standard setting.
Quality assurance and medical ethics, reduction of medical error and evidence-based medicine play a key role of the accreditation process. These systems defined, implemented, owned by the staff and finally provide objective evidence of compliance. Different types of hospital accreditation available in India is given below;
Credit Panel Empanelment management is of paramount importance for any healthcare facility to compensate patients for the money that they have invested in getting recovered from an illness or injury. Healthcare Providers are required to be a part of the network of Insurance Companies, Third Party Administrators (TPAs), Public Sector Undertakings (PSUs), Private Corporates and Government Panels to provide credit billing facility to patients. We are in the process of establishing provider network under tripartite agreements between hospital and credit panels for extension of cashless facility to Member customers.
However, the process for empanelment with these agencies is somewhat frustrating and does not encourage many Hospitals to apply for the same. Hospitals across verticals quite often and themselves inadequate to meet up the challenges. Furthermore, hospitals sometimes find themselves struggling to meet with the obligations that come with empanelment complex practices and guidelines.
Healthcare is a customer service industry. Great customer service starts with taking a patient-centric perspective. Customers' live depends on the quality of healthcare provided and the daily interactions between staff and patients.
The relationship between a patient and healthcare company is often an individual's longest engagement with any business during his or her lifetime. Developing and nurturing this relationship requires a thorough understanding of patients' expectations and perceived value of their care during the healthcare customer service experience.
A helpdesk allows easy flow of out-patients, managing departments efficiently, patient appointments, doctor schedules, medical records, etc. to help to reduce queuing at the hospitals and optimize the hospital resources deployed to serve patients. It also supports in compiling complex documents that requires for submission of claims to different credit panels especially like CGHS, ECHS, DGEHS, NDMC, etc.
A comprehensive corporate wellness program raises health awareness among employees. It can help to increase their knowledge about important health concerns, encourage them to consider healthier behaviours, and provide them with a supportive environment, from top management on down, to adopt and maintain healthy lifestyle changes.
As a company looking for successful wellness strategy, you would want a wellness program that stays with you regardless of insurance company you work with to get a win, win, win long lasting relationship.
At Insurance Mitra, we will help you solve your problems, not maintain the status quo or push you into financially unfeasible solutions. We understands your challenges and are truly interested in helping you out, even if there is some service creep
Health tourism is a wider term for travel that focuses on medical treatments and the use of healthcare services. It covers a wide field of health-oriented, tourism ranging from preventive and health-conductive treatment to rehabilitational and curative forms of travel.
India is recognized worldwide for its excellence in the medical sector. Medical Tourism in India has boosted significantly in past years and has also attained remarkable results. Advantages of medical treatment in India include reduced costs, the availability of latest medical technologies and a growing compliance on international quality standards, doctors trained in western countries including the United States and the United Kingdom, as well as English-speaking personnel, due to which foreigners are less likely to face language barrier in India.
Developing a self-regulated record and document management system is not easy as it requires extensive professional experience, skilled manpower, substantial storage-space and extra investment which further makes it complicated and more difficult for a single individual or even for an experienced organization. Perhaps that is why more and more healthcare service providers are seeking the help from third-party record management companies who are capable enough to eliminate this extra burden.
Outsourcing Medical Record Management will optimize processes, cost and employee efficiency thereby improving regulatory compliance of the hospital. With effective medical records storage and management, the entire process of delivering quality healthcare to your patients will be streamlined and enhanced.
It is mandatory for Healthcare providers, hospitals and clinics to maintain medical records for a stipulated period. Hospitals empanelled with ECHS, CGHS, DGEHS, etc are required to keep the claims documents for a minimum period of 5 years which is always an internal challenge for them.
"Operations management" concerns the planning and organizing of the administrative, financial and operational processes of a hospital to better direct and utilize internal resources. This has many phases;
Clinical care management - The health care industry is a service industry, so it makes sense when organizations make a concentrated effort to standardize protocol to improve performance. Improving clinical care management can result in reduced readmissions and improved patient-provider relationships.
Risk management - Medical practices improve when providers mitigate and optimally manage risk. Examples of risk in a health care setting range from patient or staff injuries to ballooning costs of expensive services. Hospitals can leverage predictive analytics technology to cut down on extravagant or extraneous costs while striving for improved patient satisfaction.
Business and Data analytics has the potential to radically reshape healthcare. The healthcare industry is in need of tools to control costs while improving quality and delivery of care. Improved data and metrics - in the hands of professionals with the needed analytical skills - can be used to progress almost any aspect of healthcare operation.
Data-driven business analytics offered by us can help hospitals and clinics streamline administrative tasks and free up funds for improved resources and services. Personnel can be allocated more efficiently by analyzing where and when they are most needed. Finally, data-driven improvements in the approval and reimbursement process can also ease tight cash flow, a problem for many hospitals and clinics.
Our organization provides comprehensive custom collection and receivables management solutions to mid-large sized hospitals that already possess some type of collection or receivables management platform.