Our end-to-end Revenue Cycle Management (RCM) is a cost-effective solution that is uniquely customized to improve your profits and relieve you of the pressures of hiring, training and motivating ineffective employees.
Our end-to-end RCM Services offers you the following features and benefits:
- Electronically Scanned Documents:
Documents are scanned in your offices and are seamlessly and securely accessed by TransMed using our VPNs. - Verify and Validate accompanied documents:
Documents are split into batches and reviewed for completeness, quality and readability. - Accurate Coding:
Diagnosis, Procedure Codes and Modifiers are assigned as per your descriptions and guidelines.
Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code). - We use the following industry coding standards:
• Diagnosis Codes (ICD-9: International Codes (ICD-9: International Classification of Disease)
• Procedure Codes (CPT-4: Current Procedural Terminology)
• Coding for Inpatient Services (ICD-9)
• Drug Codes (NDC: National Drug Codes)
• Dental Procedure Codes (CDT: Current Dental Terminology)
• Other Procedure Codes (HCPCS: Healthcare Procedure Coding System) - Diligent Auditing:
Six Sigma oriented Quality Control Department audits the coded charge sheets. - Process Patient Demographics Information:
Our team members process, verify and validate demographic information of patient. - Claim Submission:
Claims to be submitted to the payer electronically using a clearinghouse. - Denied Claims Processing:
Denied claims are processed, analyzed, corrected, updated and prepared for re-submission. - Extensive AR Analysis:
Experienced AR Analysts run insurance reports and identify claims over 30 days. - EOB Processing and Payment Posting:
Insurance payments are posted to the patient accounts from EOBs into the billing agencies existing software package. - Reporting:
Regular reporting enables billing agency to closely monitor performance and provide feedback to improve the process.
Key Benefits
- As the company owner, you focus your time on patient care and growing your practice and not on hiring, training, and motivating costly internal staff.
- Our billing experts assist your staff in charge-entry, payment posting and other manual chores while your billing staff focuses on negotiating payments with payers and on improving collections for your accounts receivable.
HIPAA, the Health Insurance Portability and Accountability Act of 1996, is revolutionizing healthcare information management. Any organization that electronically stores or transmits patient information must take enterprise-wide steps to adhere to HIPAA’s sweeping privacy, security and transactions standards. Essentially, HIPAA requires healthcare entities to “re-architect” how they capture, store, and transmit health data and to ensure that they protect personal health information and the privacy rights of patients.
HIPAA Compliance
Under HIPAA privacy rule, TransMed Systems falls under the extension of Business Associate. A Business Associate (BA) is any person(s) or entity that performs a function or activity on behalf of a Covered Entity (CE) and involves the use or disclosure of Protected Health Information (PHI).
TransMed considers the HIPAA regulations a call to revolutionize its overall processes and aggressively move towards a more secure deployment of electronically transmitted healthcare information. By adopting a best practices approach to privacy and security, we earn the confidence of the clients. Confidence equates to loyalty, and loyalty will help leverage our business to obtain untapped, parallel business.
We are highly conscious of handling sensitive client and patient information with the utmost confidentiality. HIPAA regulations are also of great concern to us and we take all patient information matters seriously. We are committed to delivering services and products that enable our clients to meet the requirements of HIPAA. Our industry knowledge and integrated internal business processes position us to help our clients address the challenges of HIPAA while meeting their long-term and financial goals.