keizer solutions
TRANSCRIPT
Keizer Solutions Inc.
What is
When a patient has any medical exam or procedure
Medical office will work with the patient and the
patient's insurance company for claims
Biller will submit and follow up on any claims in order to receive payment for services rendered by the health care
provider
Involves learning many codes, each one representing a symptom, medications and
diagnoses, in order to process the claim properly
Medical Billers
In charge of making sure everyone is being billed correctly.
Talking with patients and/or health insurance companies on a regular basis to make sure all invoices are paid on time
Should understand coding language and how to read medical invoices
Medical Coders
Translate the healthcare provider’s report of a patient’s visit into numeric or alphanumeric code, which in turn is used by the medical biller to make a bill, or “claim,” for the insurance company and determine the appropriate charge for the patient.
Trends in Industry
•CPT Coding
•ICD-9 and 10 codes
•Affordable Care Act
In-housePros
• Retaining Control• Return on Investment• Close Proximity
Cons• Higher Costs• Liabilities• Support Issues
OutsourcedPros
• Less expensive• Transparency• Enhanced Consistency
Cons• Hands-Off• Variable Cost• Hidden Fees
In-house v/s Outsourced Medical billing
Closer look at Keizer Solutions
• Premier healthcare services provider of medical billing, medical coding, accounts receivable management, claims processing (electronic/paper), and healthcare revenue management.
• Extensive experience in providing services in a variety of hospital-based, office-based physician specialties, A/R Management companies and their hospital clients for their credit balance account, regular accounts receivable and facility coding needs.
GROWTH through SUCCESS and SATISFACTION for our CLIENTS which will eventually lead to retaining our global leadership position in offshore healthcare business outsourcing services. This will be achieved through a strategy of complete focus in healthcare only verticals as our niche market segments and never competing with our customers, by servicing the different provider and hospital clients through medical billing and hospital A/R management companies.
Services offered at Keizer Solutions
Denial Manage
ment
Document Management Services
Revenue Cycle
Management
Coding and
Auditing
Accounts Receivable
Analytics
Credit balance resolutio
n
Ambulance
billing
Provider Enrollment & Credentialing
Pharmacy
Services
Revenue Cycle Management• Analyze accounts along with EOBs• Work all assigned accounts - big and small-balances• Resolve all accounts - inspect for patient liability or other
adjustment issues• Determine if Double Payments were made• Check for Duplicate Payments made for the same account• Many Credit Balance Analysts have earned or are earning the
designation of Certified Patient Account Technician (CPAT) from AAHAM
• KSI provides the highest levels of security, with internal-controls audit and HIPAA compliance
Ambulance billing
Our Services• Customized Billing Services• Customer Care: Friendly, Reliable,
Multilingual staff• 24-Hour Remote Access to Financial Reports• Custom Financial Reporting• Convenient Support Hours• Increased Revenue
Document Management Services• KSI Global Services addresses organizations’ document processing
challenges through a unique combination of next-generation platforms powered by artificial intelligence & fuzzy logic.
• KSI’ Smart Document Processing solutions go beyond mere capture and archival, into the realm of intelligent interpretation, helping customers automate their end-to-end document lifecycle, optimize business processes, and intelligently validate and route business information to the right persons at the right time in the right format.
• With the ability to process both, structured and unstructured documents covering handwritten, typewritten, bar-coded and check-marked information, KSI smart document processing solutions offer unmatched versatility to the client’s varying organizational document processing requirements.
Benefits
• Up to 60% reduction in operating costs• Up to 80% reduction in process turn around times• Over 99.5% accuracy in processed documents• Real-time visibility and control of business
documents• Seamless integration of validations and business
rules• Scalability to meet business volumes without
additional capital expenditure
A/R analysis and Management• Our aim is to increase collections and reduce AR days by
submitting clean claims, analyzing denied claims, and following up on each claim over 60+ days every month.
Why choose us?• Experienced AR team• Thorough and daily analysis on less-paid and denied claims• AR Follow up on all claims above 60+ days every month• AR days or DRO (Days in Receivable Outstanding) to be maintained between
43 to 45 with a threshold of 60 days• Over 120+ days AR/DRO to be maintained at below 12% with a threshold of
18%• Gross Collection rate to be maintained at 96 to 98%
A/R process
Coding & Auditing
AuditingServices include:
• IM Internal Audit• MS-DRG Validation Audit• APC- Audit• Physician Office (Pro-Fee) Audit• Interventional Radiology Audit• Cardiovascular Audit• Charge master Audit• OIG High Profile Cases Audit• Itemized Charge Detail Audit• DRG Review to include Pre and/or Post Bill• RAC Audit and Appeals• ICD-10 Review• Nationwide Staffing/Education/Training:
Quality AHIMA Credentialed Staff
Coding• High quality, accurate coding and
abstracting services• Streamlining coding operations• Improved revenue stream• Improve CMI which in turn improves
DRG-based revenues• Reduce DNFB and/or HARA levels• Reduce lost revenue• HIPAA Compliant software and billing
practices• Expertise in all Hospital Coding Service
Types• Expertise in all Physician Coding Types:
CPT and HCPCS Coding• Credentialed staff including RHIA, RHIT,
CCS, CCS-P, CCA, CPC, and/or CPC-H.
Contact Us
Talk to our online representative
Live Chat: www.keizersolutions.com
Follow us on:LinkedIn: Keizer Solutions Inc.Facebook: Keizer Solutions Inc
Twitter: @keizersolutions