Revenue Cycle Management

Medical Billing Services

ReTech offers a comprehensive range of Medical Billing Services & Revenue Cycle Management Solutions tailored specifically for Hospitals. By harnessing the power of people, streamlined processes, and cutting-edge technology, we are able to deliver operational and financial solutions that are designed to meet the unique needs of our clients. Our primary objective is to assist hospitals in maximizing their reimbursement potential while simultaneously reducing the overall cost associated with Revenue Cycle Management (RCM).

Our suite of services encompasses a wide array of critical functions including Medical Coding, Charge Capture, Payment Posting, and Accounts Receivable Follow-Up. These services can be availed on a standalone basis or as part of our complete RCM offering.

At ReTech, we are committed to delivering end-to-end solutions that go beyond just improving account receivables. Our comprehensive back-office and knowledge-processing solutions have consistently demonstrated the ability to drive a definitive increase in operating margin for our hospital clients.

The productivity and profit margins of our clients have experienced a significant boost as a result of our tailored solutions. This has not only helped them bridge the capital investment gap for upgrading existing healthcare services in India but has also provided them with the necessary margins to effectively address the new challenges that continue to emerge within the healthcare industry.

Why ReTech?

At ReTech, our commitment extends beyond just delivering quality results. We believe in creating a seamless and delightful experience in all our business operations, setting us apart from the rest. With years of expertise spanning across national boundaries, we have gained the trust of our clients through our proven track record of delivering exceptional results and achieving milestones together.

For us at ReTech, it’s not simply about the cost, but about the value we bring to the table. Our focus has always been on building this value by consistently providing our clients with top-notch deliverables, and this is a commitment that ReTech will continue to uphold.

At ReTech, our value proposition is simple: we help you get paid more and faster. By taking on the most time-consuming and costly medical billing work for you, we free up your time to focus on what matters most – providing excellent patient care. Our team is dedicated to staying on top of the latest payer intelligence, ensuring that you benefit from the most up-to-date information to maximize your reimbursements.

In addition to streamlining your billing process, we provide full clarity and visibility into your practice’s financial performance. With our comprehensive reporting and analytics, you can make better informed decisions to optimize your revenue cycle management. Whether it’s identifying areas for improvement or recognizing trends in your billing patterns, our insights empower you to take control of your practice’s financial health.

ReTech value Proposition

With ReTech, you can trust that your billing needs are in expert hands. Our professional team is committed to delivering unparalleled service, accuracy, and efficiency, so you can have peace of mind knowing that your revenue is being maximized. Let us handle the complexities of medical billing so that you can focus on what you do best – caring for your patients.

Experience the difference with ReTech and unlock the potential for increased revenue and improved cash flow. Get in touch with us today to learn more about how we can support your practice’s financial success.

Medical Coding

Your Coding Partner for

Healthier Reimbursements: ReTech Solutions

Renowned for its high-quality medical coding services, ReTech is dedicated to offering tailor-made solutions to meet the unique needs of its clients. With expertise in radiology, internal medicine, hospital coding, among others, we are recognized as leaders in the industry for providing medical coding and billing services outsourcing. Our team of certified medical coders guarantees precise coding, accurately reflecting the value of your services and ultimately resulting in improved reimbursements for your healthcare facility.

Medical Coding Services

Medical coding is an essential component of the healthcare sector, playing a vital role in diverse administrative and clinical operations. By translating intricate medical details into alphanumeric codes, healthcare facilities can accurately submit claims to insurance providers, maintain uniform and comprehensive medical records, and monitor public health trends. Furthermore, these codes are crucial for both procedural and diagnostic purposes, ensuring accurate documentation and communication of the provided services and procedures.

The process of medical coding necessitates a deep understanding of medical terminology, anatomy, and physiology, along with a comprehensive grasp of coding regulations and guidelines. Precision and meticulousness are fundamental in this field to prevent billing inaccuracies and ensure that healthcare providers receive rightful reimbursement for their services.

Moreover, the utilization of standardized codes facilitates data analysis and research, empowering healthcare entities to recognize trends, evaluate outcomes, and enhance the quality of patient care. As the healthcare landscape continues to develop, medical coding remains a pivotal function that underpins efficient and effective healthcare delivery.

Medical Coding Matrix

With extensive experience, particularly in the Healthcare BPO sector, ReTech offers comprehensive Medical billing and coding services. Our efficient administrative processes ensure a steady and robust cash flow. ReTech’s skilled medical billing and collection professionals possess thorough and current knowledge of various healthcare procedures, plans, processes, and obstacles.
We adhere to industry-standard practices, employ technology, adhere to quality audit procedures, and utilize various medical software to improve the timely execution of billing and collections.
Our domain expertise has empowered our clients to improve billing cycle quality, increase collections, reduce rejections, and achieve successful claims settlements.

Charge Entry Services

Accurate charge entry is critical in medical billing, as it determines the correct value for patient accounts based on coding and fee schedules. Physician service reimbursement depends on the input costs, making it essential to avoid charge entry errors to prevent claim denial. Effective collaboration between coding and charge entry teams is beneficial for optimal results.
ReTech boasts a skilled team of medical billing professionals well-versed in handling multi-specialty charge entry and conducting thorough demographics checks. The significance of precise charge entries lies in their direct impact on cash flow. ReTech guarantees flawless and precise entry for error-free claim submissions.

As a trusted medical billing provider, ReTech offers efficient & reliable services across different healthcare specialties.

Our charge entry process comprises of following steps:

At ReTech Business Solutions, we meticulously manage the medical billing charge entry process to ensure precision and efficiency. We are aware of the significant impact even minor errors can have on a healthcare organization’s cash flow. Hence, we prioritize delivering exceptional services by adhering to a methodical approach.

  • Receiving superbills documentation via FTP and other secure transmission methods
  • Recording details such as date of service, billing provider information, Referring Provider, POS, Admission dates, CPT, ICD-10 codes, units, and modifiers
  • Forwarding claims to the clearinghouse or Insurance carrier

Claims Submission

More than 75% of providers currently submit claims electronically and the trend is increasing. Electronic submissions besides speeding up the claim submission process also speed up the A/R.

Submitting electronic claims through a clearinghouse has become essential in today’s healthcare industry. As employers seek more cost-effective coverage plans due to rising healthcare costs, eligibility issues arise. The process is intricate, consuming significant time and resources. Our team, consisting of healthcare experts and medical coders, ensures accurate claim preparation and submission based on Practice-provided information. Following claim submission to clearinghouses or insurance payors, our team tracks claim status and reimbursements.

ReTech’s Claims
Submission Services

Collecting Receipts

The first task involves obtaining a comprehensive invoice from the healthcare provider, detailing all the services rendered to the patient, along with their respective costs and relevant therapy codes. The ReTech team will support you in assembling the required documentation and invoices.

Filling for Claim Forms

The claim form contains information regarding the patient’s medical condition and the services provided, as well as determining whether the client’s insurance covered the expenses. ReTech aids in completing the claim form by furnishing the following details:

  • Personal information (such as Name, Address, and Date of Birth)
  • Policy number and insurance group
  • Patient’s background and reason for the appointment
  • Healthcare provider’s name and address
  • Any previously paid patient expenses

Review and Submission

Once all claim information has been inputted, our team will create a backup of all documents and forms. We will meticulously review everything and make any necessary adjustments. Prior to submitting the final form, we will contact the insurance company to check if any additional documentation is necessary. The completed claim form, along with all required documentation, is then submitted to the insurance provider.

Claims
Submission Process

  • Procure detailed invoices from a medical service provider
  • Support in gathering necessary paperwork and receipts
  • Help with completion of Claim Forms (personal details, insurance information, expenses, etc)
  • Generating backups
  • Examining data and implementing essential amendments
  • Pursue updates from insurance providers regarding document requirements
  • Lodge claims along with essential documentation to insurance companies

Payment Posting

Payment posting is a crucial stage in medical billing that guarantees patients are invoiced for the healthcare services they receive. The precision of medical billing payment posting, which is the final stage in the billing cycle, is crucial for an efficient revenue cycle. ReTech’s team of payment posting professionals ensures the prompt and accurate entry of information. We guarantee that payments are allocated to the correct accounts and reconcile them with the bank’s deposit sheet on a daily basis to alleviate accounts receivable workload. After the posting of payments to patient accounts, any denials can be handled. Diligent attention to detail and a rapid turnaround time are vital components of the medical billing payment posting process.

Annual Provider Credentialing

Numerous healthcare organizations choose to outsource payment posting services to ReTech because of the company’s established track record in quality management and information security. For years, we’ve been dedicated to adhering to best practices, guaranteeing that the outsourced medical billing payment posting process aligns with industry standards and business needs.

The Process

  • The ReTech team will review and assess the EOB thoroughly.
  • All clean charges/claims will be posted by the ReTech team within 24 hours of receiving complete information for posting. Additionally, adjustments and denials will be posted promptly to identify and address any recurring issues.
  • In the event of non-clean charges/claims, the clients will be notified within 48 hours upon becoming aware of them.
  • We will furnish EOB analysis related to receivables, frequency of cash inflows, and any denials or remittances.
  • By monitoring cash inflows, we can promptly address delayed payment follow-ups.

Our Assurance

ReTech’s team of Payment Posting experts focuses on ensuring the prompt and accurate entry of information. We are dedicated to correctly placing payments into the appropriate accounts, while performing daily reconciliations with the bank’s deposit sheet to minimize the workload on accounts receivable. By posting payments to patient accounts efficiently, we can expedite the handling of denials. Our commitment to meticulous attention to detail and a rapid turnaround time is pivotal in the realm of medical billing payment posting. The ReTech team adheres to a Turnaround Time (TAT) of less than 9 hours, maintaining an accuracy level exceeding 95%. We actively engage as a collaborative partner in ERA posting, Manual Payment Posting, and Denial Posting processes.

Account Receivable Management

Are you looking for an effective system to efficiently manage and oversee your accounts receivable and collections? Are you struggling with limited resources to optimize your accounts receivable processes for better cash flow? If so, outsourcing healthcare accounts receivable services to a skilled service provider could be the best solution for your organization.

Hospitals and healthcare providers are primarily focused on patient care and often lack the time and resources to effectively handle aging accounts receivable collections. With a substantial volume of old healthcare accounts receivables continuously aging while attending to new medical cases, the management of these claims becomes challenging. Due to demanding schedules and time constraints, hospitals may lack the capability, skills, and expertise to address these aging claims effectively. Consequently, inefficient management of healthcare accounts receivable may lead to missed opportunities for reimbursement for healthcare practices.

Is your hospital or healthcare facility experiencing a similar situation? Have you noticed that your staff is overwhelmed with accounts receivable management? If that’s the case, consider ReTech for outsourced healthcare accounts receivable management.

Why Outsource AR Management Services to

ReTech Solutions?

ReTech, is a outsourcing company, boasts extensive expertise and experience in providing medical AR collection services to healthcare providers worldwide. By entrusting your AR Management services to ReTech, you can take advantage of proficient, cost-effective, dependable, and specialized healthcare accounts receivable solutions.

At ReTech, we have a skilled workforce with expertise in handling both legacy and current accounts receivables for global healthcare organizations. Outsourcing to ReTech allows your organization to save valuable time and effort. While your staff concentrates on healthcare delivery, rest assured that all your medical accounts receivable collections are being managed. With our effective follow-up communications for your AR Management, you can be certain that you will have the necessary funds to meet your operational requirements. For a more effective and efficient collaboration, contact us today!

The two most key features that ReTech focuses on are:

AR analytics and AR follow-up

AR analytics

How have the different categories of money owed to the company performed over time?
• What do changes in the performance of these categories indicate?
• What is our current situation regarding the money owed to us and how is it divided by age categories?
• What is our level of risk, particularly for money owed that has exceeded a certain threshold?
• Are we handling and resolving disputes effectively?
• Are there any outstanding debts that we may need to write off or escalate to collections in the future?
• What amount of cash can we expect from future money owed to us? How much of the future debts do we anticipate will be collected?
• How long does it take for money owed to be converted into cash, and how does this compare to our planned timeline?
• What specific actions do we need to take in order to achieve our target for the number of days it takes to collect payments from customers?
• How likely are these efforts to be successful?

AR follow-up

Our AR follow-up services include the following:
• Managing various payor mixes to meet client requirements
• Promptly investigating claim denials and taking action within 48 hours of notification
• Following up on all outstanding claims
• Prioritizing AR based on value and aging • Monitoring receivable balances
• Reviewing accounts with balances over 60 days past due to ensure effective resolution
• Taking action on returned mail within 48 hours
• Maximizing revenue
• Striving for less than 10% of accounts receivable to be over 120 days old
• Working to decrease claim payment turnaround time

Benefits of partnering with ReTech

Cost-effective rates
• Protection of data
• Adherence to HIPAA regulations
• Accurate accounts receivable management
• Proficient and seasoned team
• Rapid processing
• Flexibility for growth
• Accessible round the clock
• Improve cash flow and minimize operational expenses

Denial Management

Effective denial management is a crucial component for ensuring a successful revenue cycle management (RCM) in the healthcare industry. Many physicians, doctors, and other healthcare professionals consider the denial of medical claims to be their most pressing issue. Repeated denials or a rise in denials can result in substantial operational losses that are often challenging, and in some cases impossible, to recoup.

The primary reasons for denial management include:
• Incomplete information, such as missing or inaccurate patient demographic details and technical errors
• Incorrect or omitted ICD-10 diagnoses
• Incorrect or omitted CPT-4 modifiers

Our Denial Management Services

Pinpointing the Most Prevalent Reasons for Denials

The initial step is to determine the cause for the denial of a claim. Upon the return of unpaid adjudicated claims, the payer provides a status code along with the rationale for the remittance. Understanding the common and subtle grounds for frequent denials might mandate a comprehensive assessment of your billing protocols and administration. Following this, our team will precisely locate the issue to investigate and rectify, aiming to decrease denials and enhance claim processing efficiency.

Sorting and Categorizing the Denials

After establishing the quantity and reasons for denials, the subsequent task involves categorizing them for trackability and referral to the corresponding department for resolution. Through sorting and scrutinizing denials by category, areas for improvement in processes, workflows, or the expertise of employees, physicians, and clinicians can be identified.

Installating a Tracking System

Developing a reporting and tracking framework post categorization of reasons for denial enables swift access to vital information, including the most prevalent denial types that affect the organization:

  • Leading payers impacting the organization in terms of dollars from denied claims
  • Influential areas and departments affected by denied claims.
  • Monitoring and Proactive Measures

Denial management requires ongoing scrutiny and assessment for preventing revenue loss. The denial management team at ReTech facilitates the following:

  • Establishing a diverse team to examine denial data jointly, identify priority categories, and discuss resolution strategies.
  • Carrying out routine meetings with the interdisciplinary team to focus on specific denial categories.
  • Continuous evaluation of the internal controls’ efficacy in managing and averting denials.

Ready to Grasp Every Opportunity!

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