This is where we can make a big difference. Our proactive and streamlined revenue cycle management process gives you complete visibility and assurance of your payments – starting from charge entry to claims submission through payment follow-up.
We have been successfully serving healthcare providers in every domain – physicians, hospitals, urgent cares, and durable medical equipment. Our billers and coders are proficient in working in several industry-standard practice management and billing systems and have an excellent track record in delighting each customer through their expertise, dedication and steady focus on making you realize your payments on time.
Our range of services for healthcare providers produces significant cost advantages that include, but are not limited to, savings in cost of billing operations and higher revenue and cash flow due to reduction in denial rate and increased payment from payers.
We welcome you to explore our widely acclaimed range of solutions geared for healthcare service providers just like you. We will be glad to offer you our powerful yet cost-effective services to help you take your business to the next level of success.
Providing billing services for Durable Medical Equipment (DME), or Home Medical Equipment (HME) as they are sometimes called, can be a time-consuming and tedious affair. Among other things, it requires in-depth knowledge of reimbursement guidelines of Medicare, Medicaid, and Commercial Plans, and their caveat. It also requires a constant adherence to quality and staying abreast of all the changes happening in reimbursement regulations and coding & documentation requirements.
We have a highly capable team of DME billing experts who can make life easier for you from the very first day. With us by your side, you can leave all your DME billing worries to expert care. Outsourcing your DME billing requirements to us will allow you and your staff to concentrate on marketing, growing, and running business operations, rather than managing a billing and collections department.
Our experience shows that the process for DMEPOS billing can be cumbersome due to its inherent nature, due to the order getting generated from a physician’s office. This increases complications and the turn-around time as dependencies increase. DME, Prosthetics & Orthotics companies need to devote much time to coordinating and communicating with the ordering physician’s office for a valid Rx, medical/therapy notes, etc. Equipment that requires prior authorization also involve innumerable follow-up calls. This is managed effectively by us through our methodical and streamlined process that tracks each request in detail ensuring timely follow-up. Payer guidelines are specific to diagnosis and a thorough knowledge of this result in drastically reducing denials. Our diligent physician and payer follow-up activities also help reduce turn-around time and improve cash flow. The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.
- Follow-up on incomplete prescription with physician’s office
- Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
- Error free patient entry
- Error free sales order creation
- HIPAA compliant
- Real time transaction audits
- Primary and secondary insurance verification
- Insurance verification for rental items
- Obtaining authorizations & extending authorization
- Open order audit and clean-up
- CPAP user compliance tracking and counseling calls to non-compliant patients
- Claims submission within 48 hours of receiving proof of delivery
- Rejection follow-up within 24 hours
- Tracking and follow-up of partial or incorrect payments
- Denial management based on detailed analysis
- Methodical and proactive AR follow-up
- Timely payment posting to reflect accurate AR
- Customized reporting
- Claims submission
- Collections
- Denials
- Accounts receivables
Our medical coding and billing services are designed to address a wide range of issues and challenges faced by hospitals and physicians while realizing payments. By leveraging efficient processes and billing workflows, we help to improve productivity and quality, which in turn reduces operational cost and boosts revenue generation. Our billing process experts can provide customized solutions to help you achieve your business objectives. These solutions not only dramatically improve efficiency in a manner which is surprisingly cost-effective, but also allow you to focus on the more important aspects of your business.
Medical billing involves accurate interpretation of SOAP notes for correct coding combinations based on payer specific guidelines. A thorough understanding of the nuances associated with various physician specialties is required. This drastically reduces denials, which in turn leads to a significant reduction in days in AR. Denials due to incorrect entry of demographics are minimized through our transaction based internal audit mechanism. Rejections are worked as a priority to reduce turn-around time and detailed analysis of denials helps identify changes in payers’ reimbursement guidelines. Systematic follow-up is also conducted that minimize the possibility of untimely denials while ensuring their early identification, requests for medical notes, etc. All claims that have not been closed out in the system are categorized by age and insurance for effective management of the follow-up process. Billings of secondary claims are also followed up to reduce the patient’s financial responsibility while ensuring better collections.
- Accurate coding combination, i.e. service code, diagnosis code, modifiers and place of service code
- Error free patient entry
- Real time transaction audits for patient and charge entry
- Claims submission within 48 hours of receiving patient (demographic & insurance) and service information
- Rejection follow-up within 24 hours
- Tracking and follow-up of partial or incorrect payments
- Denial management based on detailed analysis
- Methodical and proactive AR follow-up
- Timely payment posting to reflect accurate AR
- HIPAA compliant
- Customized reporting
- Claims submission
- Collections
- Denials
- Accounts receivables
Our AR follow-up process monitors and proactively pursues collection of payments. All claims that have not been closed out in the system are categorized by age and insurance for effective management of the follow-up process. Calls are initiated for claims that are 31 days old or more. We attempt to identify the source of the problem through proactive calling so that the turn-around time on collections can be reduced.
Diligent follow-up for paper submissions ensures that “claims not on file” are resubmitted within filing limits. Weekly AR Reports are analyzed and reviewed to prioritize work for the week. All interactions with payers are documented in detail, making repeat follow-ups streamlined and more effective. Our experienced team is adept at gathering information through appropriate probing questions. Findings are communicated with clients through a detailed report on a daily basis. The report also includes suggestions for actions to be taken from the client’s end e.g. resubmitting with medical notes, or with modifier/coding changes, and so on.
Every cash amount receives the same degree of attention as the other, irrespective of its size or source. Combine that with our high accuracy standards and you can rest assured that every penny you are entitled to will be claimed and recovered by us in the shortest possible time! Moreover, our knowledge of pertinent federal laws and acts such as EMTALA (Emergency Medical Treatment and Labor Act), ERISA (Employee Retirement Income Security Act), the Prompt Pay Law and others, help in resolving issues and settling accounts much faster than other AR Managing companies.
- Streamlined and improved workflow using effective tracking tools
- Multiple follow-up calls for same claim
- Follow-up on all paper submissions
- Payer specific analysis
- Detailed reporting with suggestions for actions to be taken
- Improved cash flow
- Reduction in turn-around time
- 100% HIPAA compliant
In fact, this is one of the biggest worries of any payer. Is your money going toward a just claim? Are you paying for a genuine cause? Are you sure that you are not being asked to pay for a service that you do not cover?
With our wide range of specialized services tailored for payers like you, Future Health care is uniquely equipped to take care of all such worries quickly, professionally, and in a highly cost-effective way.
Take a look at our various solutions and get in touch with us today.
We are a pioneer in the claims process outsourcing arena with proven demonstrable experience in insurance claims adjudication. We implement procedures and systems that are HIPAA complaint to process and adjudicate medical claims. Our customers are attracted to our remorseless pursuit of quality (we offer 99%+ accuracy at claims level). Our processing timelines comply with CMS guidelines. Our claims adjudicators are trained in several industry standard claims adjudication software and can adapt to any claims adjudication system within a short period.
- Verification of all keyed fields in case of claims that are not submitted electronically
- Determination of member eligibility and coverage
- Primary insurance verification
- Determination of timely filing limit of claims
- Confirmation of provider status (participating / non-participating).
- Checking authorization notes for instructions and applying authorization status to claims
- Identification of duplicate / corrected / interim / final submissions
- Determination of DRG
- Apply case-rate / per diem to services within the purview of the case-rate / per diem contract
- Determination of correct allowable
- Ensuring that co-pay, coinsurance, deductible, and OOP are accurately calculated and applied as per the benefit plan
- Use of appropriate remark/adjustment codes
- Real time audits
- Customized reporting
- Inventory Report
- Quality report
- Production report
- Pend report
- Skip Report
Credentialing is the process of obtaining, verifying, and evaluating qualification of a provider and determines whether an applicant is qualified to be a participating provider with the organization.
We are happy to aid provider groups as well as clients with a complete range of credentialing services through a time-tested technique that ensures that organizational providers are compliant with state and regulatory bodies before directing membership to these facilities.
Proper credentialing requires a watchful eye for total and stringent compliance with applicable standards. It also requires that applicants are evaluated in the right manner and their competencies are measured accurately. For this, a number of resources are consulted such as the social, academic, and professional history of the applicant, peer and expert reviews, end-user reviews on the quality of the applicant’s services, and more.
We are fully equipped to take care of all these requirements quickly and efficiently. We approach the subject in an organized and systematic manner. The key steps in our credentialing process are as follows:
- Full range of credentialing services
- Re-credentialing after every 3 years
- Regular update of provider data in credentialing and claims systems
- Generation of all pertinent reports like
- HSD Report
- Physician and Facility Reports
- Weekly ADD/TERM report
- Delegated credentialing report
- Group/taxonomy etc. specific ad-hoc reports
We work with a full team of credentialing veterans who strictly abide by the standards and guidelines set within Medicare Managed Care Manual and National Committee for Quality Assurance (NCQA). So, why look anywhere else?
The Billing and Collection team provides customized and decisive solutions to Medicare and Medicaid HMOs, Commercial Insurance plans, as well as PBMs, enabling them to achieve sustainable results. Our certified public accountants and financial analysts manage each process, using our robust data warehouse and state-of-art technology.
We are fully equipped and well-positioned to cater successfully to all the needs of our clients, providing them with sound, full-cycle billing, and collection solutions. All of these solutions are implemented in a surprisingly cost-effective manner.
Our Billing and Collection services include:
- Data Preparation and Entry
- Accounts Payable and Receivable
- Premium Billing
- Payment Tracking/Logging and Member Premium Reconciliation
- Plan to Plan Reconciliation
- Risk Management
- Report Generation, including DOI (Department of Insurance) Reporting, Cash Flow Statement, Segmental Report etc.
- Risk Sharing and Yearly CMS Payment Reconciliation
Utilization Management is the evaluation of the appropriateness and medical need of health care services, procedures, and facilities, according to preset criteria or guidelines while also under the provisions of an applicable health benefits plan. It is a critical and core component of the healthcare system in the US and requires professional expertise to a very high extent.
We specialize in providing our clients with a full range of Utilization Management services for Part A, B, and D. Trust our accurate and timely reports, strict adherence to UM codes, efficient evaluation by qualified medical professionals, and proven expertise to bring you robust and reliable Utilization Management solutions.
If cost-effective Utilization Management services are on your mind, look no further than here. Contact us today!
- Dedicated team comprising physicians and pharmacists
- Medical transcription of clinical notes to aid in decision making in client specific systems
- Collection of additional clinical information from physician’s office
- Final decision made by qualified physicians and nurses in the US
- Reducing the standard procedure turnover time from CMS mandated 30 days to 7 days for Part A & B Utilization Management and from 72 hours to 48 hours for Part D Utilization Management
- Expedited procedure to determine authorization within 24-36 hours
- Standardized process and effective application of appropriate tools before rendering any decision
- Specialized clinical customer support 24/7 Help Desk
Future Health care is proud to bring you a powerful range of software development and IT support services that can make all the difference to your business.
We boast of an experienced and highly skilled in-house team of coders, designers, database administrators, software developers, and IT professionals, who are ready to provide you with powerful proprietary applications and fast enterprise solutions to improve your processes and cut costs like never before.
Get in touch with us today and discover how you can surge ahead of your competition.
We help clients build and maintain a flexible and secure IT infrastructure. With our experience in maintaining health care IT systems, clients can rest assured about their data security while complying with industry standards and best practices such as HIPAA, ISO 27001:2008, etc.
We offer valuable guidance to our service-users on how to systematize, maintain, and manage their software assets, consistently and faultlessly, throughout their life-cycle. Our competent IT professionals provide clients with an exhaustive range of solutions, allowing maximum cost-containment and addressing their business challenges effectively.
- Business Analysis and System Design
- Technology Architecture Consulting
- Application Software Development
- Maintenance and Technical Support
- Production Support
- Troubleshooting and Issue Resolving
- Managing Updates and Patches, and more!
We have experience and expertise in working on many platforms and systems including Java (Java SE/EE, Struts, Spring, Hibernate/JPA, Axis), Web Application Servers (Tomcat, JBoss) and Databases (Oracle).
Combine our proactive consulting services, technological know-how and domain expertise, and you’ve got an explosive mix to improve your process efficiency, streamline administration, multiply profits, and blow the competition away!
We provide comprehensive multi-level support solutions for our clients with our skills and expertise in a wide range of IT systems. Combined with 24/7 automated systems monitoring and round the clock support personnel, we assure prompt issue resolution helping us maintain strict Service Level Agreements.
We are capable of providing solutions and support across various IT systems.
- Microsoft Active Directory Domain service management with multi-domain infrastructure
- Manage and optimize cross-platform in-house and external web hosting services
- Manage and monitor email systems such as Microsoft Exchange 2013, Microsoft Office 365, Google Apps for Business, etc.
- Design, implement, and maintain business application server infrastructure
- Design and implement scalable virtual systems
- Manage telephony systems Avaya IPO and communication manager
- Manage, monitor, and support cloud hosted telephony systems. RingCentral, 8x8, etc.
- Design, implement, and support Call center systems with IVR, ACD, skill-based routing, recording and reporting
A doctor to patient video teleconferencing platform with built in EMR, medical billing and health capabilities that requires little to no up front expense for implementation and no additional out of pocket expenses for patients with the benefits of being payer neutral and HIPAA secure.
Key Facts
Comprehensive end to end telemedicine solution
No upfront cost, software to purchase, or implementation costs
Customizable telemedicine platform to meet your program goals
Only computer, laptop, or smart phone required
HIPAA & PCI Payment Compliant
Scheduling, medical billing, & collections included
Our Telemedicine Solutions are applicable to the following:
Hospitals
- Reduce Re-admissions
- Reduce Emergency Room wait times
- Increase Patient Satisfaction
- Customizable telemedicine programs
Home Health Care
- Reduce transportation costs
- Increase provider specialist access
- Minimize transportation costs
- Maximize staff efficiency
Nursing Home
- Improve state survey scores
- Increase provider specialist access
- Decrease hospitalizations
- Generate revenue through Medicare reimbursements*
Assisted Living
- Offer provider visits on-site to distinguish your community
- Decrease ER visits with immediate access
- Increase patient and family satisfaction
- Integrate with remote patient monitoring
Insurance Plans
- Improve state survey scores
- Save on transportation costs
- Reduce preventable Urgent Care and ER visits
- Maximize the provider network
- Avoid ER visits and inpatient hospitalizations
Healthcare Providers
- Generate revenue on off-hour calls
- Work from home, office, or virtually anywhere
- Grow your income by connecting with new patients
- Expand your patient geographical reach