HealthCare KPO Contents

Transcription

1 HealthCare KPO Contents About us... 2 Healthcare SBU... 2 Patient Management Support:... 3 Medical Records:... 4 Medical Transcription... 4 Medical Coding... 5 Revenue Cycle Management:... 5 Data Management Services... 6

2 About us Business Process Outsourcing W.L.L. (BPO+) has unique heritage, which has contributed to our deep understanding of processes. We began in 2006 as a Joint venture between an IT & BPO giant from India and Al-Bahja, Oman. Our charter was to provide Business Process Outsourcing services in Qatar. During the 6 years that followed, we earned the opportunity to manage a wide range of processes from the simple to complex, operating across Qatar. Over these years BPO+ has established a leadership position in the Voice and Non Voice based Customer Service segments while expanding services across all verticals. We have robust and displayable expertise in managing customer expectations by providing efficient services while also controlling costs for our customer. BPO+ offers customized and comprehensive customer care solutions to the Telecom, BSFI, Government, Education and various other segments in MENA region. We have a strong domain and operation expertise across all voice based solutions. To support all the above BPO+ has state of the art technology and infrastructure and stands the advantage of providing multilingual delivery capabilities in the centre. Today, BPO+ is one of the largest BPO & ITES companies in GCC region. In Healthcare domain we support the (almost) entire life cycle of the Healthcare/Hospital Management. From Outpatient support to Revenue Cycle Management we support all external aspects for two of the largest Medical institutions of the country thus supporting circa 6 of the largest hospitals in Qatar. Healthcare SBU BPO+ entered the Healthcare domain circa 2 years back with a mandate to setup and manage a contact center for one of the largest private medical institution in Doha. This contact center opened up the doors to the wide range of hospital support programs and processes for BPO+. Being pioneer in the market and realizing the size and scale of the opportunity BPO+ setup the Healthcare SBU to concentrate on developing this domain. The SBU was established under direct guidance and supervision of our CEO (Dr. Tejinder Singh) who had in past setup & managed various large Medical transcription companies (still operational) in India. Slowly and gradually the SBU started establishing itself and currently supports the largest government managed hospital chain under the initiative of Center of Healthcare improvement apart from the Private hospital with which it started work initially. Overall SBU is further divided into verticals according to segment of Hospital/patient lifecycle they support. Below are the details of work being done in each vertical:

3 OPD & Patient Management Support Revenue Cycle Management Inpatient Information Support Medical Records & Digitization Information Dissemination & Management Support Doctors Schedule Information Support Patient Management Support: Our patient Management Vertical supports as a patient (in and out) interface for 5 hospitals through call center run by Center of Healthcare improvement (Government body) and an onsite call center at 1 of the largest and most premier Private hospitals in Qatar. From these call centers our employees answer circa 10,000 calls per day helping patients and their friends & families for all queries regarding Appointments (booking), Confirmations, Reschedule, Cancellations, Reconfirmations, Inpatient information, Doctor s schedule information, Doctor s Leave information and much more. Out employees are trained and qualified to act as on and off line subject matter experts (SMEs) in patient support and ensure emphatic & courteous support to the patients and their dear ones. They are trained to review the patient history and intelligently answer and resolve patient queries and appropriate reschedules (as per the patient history and requirement). They are also trained and qualified to liaison with different departments of the hospital to coordinate and assist any kind of emergency or urgent requirement by or for a patient. Our patient satisfaction starts even before they meet you Schedule appointments both outbound and inbound Capture comprehensive patient information even before visit, including demo and coverage, past visits, pre existing conditions etc. Download schedules from hospitals or clinics via EDI or secure transfer Check for physician availability and schedule Verify the patient details provided during the call

4 Verify coverage on all Primary and Secondary (if applicable) Payers through Payer Web Sites, WebMD and through phone calls Contact patient for information if necessary Provide the results which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information and much more Medical Records: Our Medical records vertical is further divided into two parts 1) Medical Transcription and; 2) Medical Coding Medical Transcription BPO+ is the pioneer in Medical Transcription Services providing its transcription services to healthcare providers across Qatar, and many other Middle East countries. Our medical transcription services are available for individual physicians, clinics, and hospitals. Our quality medical transcription services are highly cost effective at quick turnaround time from 2-24 hours. At BPO+, through its inhouse MT center and offshore MT services partners offers highly secure (adhering all rules and norms of Health Insurance Portability and Accountability Act (HIPAA) services. We maintain high degree of security by keeping close supervision on the medical transcriptionists to eliminate its misuse. We take additional security measures to ensure your peace of mind even on Outsource Medical Transcription. Our partners have transcribed millions of lines during our few years of medical transcription existence, and have developed ourselves to provide all medical transcription service requirements. Our clients provide us the files through handheld recorders, where they dictate the reports of their patients into digital or analog recorders. We transfer the dictations from these recorders to computer, and the upload to secure Ftp of our partners or provide these to our inhouse transcriptors as the case may be for the client. Some Benefits Of Using Our Services We offer end to end solution (hardware + software included) Dedicated account manager assigned to each account Customized solutions Competitive pricing Fast Turn Around Time High accuracy 99% or more No minimum volume commitment

5 Medical Coding The business of coding as always been complicated and the demand for coders and coding services is ever so increasing. The industry s ability to meet this demand for coding and chart auditing is limited in the near term. At BPO+, we use our more than 50 man years of coding management experience (inhouse and partners) to design high quality coding services. Compliant, accurate and fast coding services are delivered by certified and experienced coders with very high academic qualifications. Combined with a global delivery model, we are doing our bit in helping the Qatar healthcare properly report the services provided and coding services while fulfilling all the requirements of confidentiality, compliance and speed. All our coders use technical assistance for coding accurately and productively. Our training techniques involve imparting best in breed practices that puts our coders ahead of the industry in terms of productivity. Most of the Institutional and State rules, guidelines and regulations are programmed as edits to ensure these are followed without exceptions. Wide range of Coding Services Accurate multi-specialty E & M, CPT, DX and HCPCS coding Chart audits and Concurrent/retrospective documentation reviews Chart abstraction or HCC Coding Short-term or long-term coding support to complete outsourcing Billing and coding education / training for coding and billing staff ICD 10 AM training and implementation support I level DRG audit Complex DRG audits CMS Pricers DRG Calculators Revenue Cycle Management: In a country where most of the healthcare is covered by the government or Insurance companies, managing RCM is a whole lot different from the rest of the world. Our role in the hospital revenue cycle starts at the time when we support them in MT or Coding, further we support hospitals on insurance eligibility, charge capture, claims coding, claims submissions, claims clearinghouses, and back-end follow-up with insurance companies to rectify claims denials and resubmission requests. Our RCM services include (amongst others): Patient Registration Claims Submission Medical Coding

6 Charge Entry and Cash Posting A/R Denial Management A/R Collections and Follow-up Data Management Services Apart from all the above we also support Insurance TPAs through our Document Management Services Sub unit, where we support by scanning, digitizing, indexing and mapping claims.