Medical Billing and Coding Services

Medical Insurance Verification Specialists- Global Edge Usa, LLC

2009-07-09T15:39:00.000-07:00

Global Edge is offering Medical Insurance Verifications Specialist Services to heath care companies, hospitals, medical supply companies, DME’s ‘durable medical equipment companies’, surgery centers, clinics, doctor offices etc. We are a third party company specializing in insurance verifying process utilizing our trained specialists, located in the Bay Area California!

Our Medical Verification Specialist actually makes outbound calls to large insurance carrier groups to obtain eligibility information. Then, provide the information collected to our clients or update the same into their internal system directly. We will answer all incoming calls from providers, recipients and other entities in relation to insurance coverage. In addition to making outbound calls, we also research eligibility information using various online eligibility systems.

Verification Process:
We verify insurance eligibility and benefits for patients and obtain pre-certifications or authorizations if needed. This process minimizes the risk for claim denials and maximizes reimbursement for services rendered.
We support hospitals and healthcare companies by providing high quality service, while protecting the institution’s financial viability. Timely and accurate insurance information of patient account directly affect the institution’s financial bottom line.

What we can do:
Verify insurance eligibility and benefit of patients by actually calling the insurance carrier.
Verify demographic information and update patient accounts.
Ascertain if authorization is required for schedule procedures.
Obtain verbal and written authorization for medical treatment from appropriate sources.
Verify insurance information for accuracy and completeness; resolve all discrepancies.
Communicate any financial responsibilities or additional information necessary for processing the insurance.
Process all information received from intake/service personnel

Our entire Insurance Verification team possesses:
• A Minimum of 3-4 years of Call Center/Customer Service experience.
• Excellent knowledge of healthcare terminology.
• Internet capability and excellent computer skills

To inquire more about our services:
Call us: 510-257-4563,
Email us at info@GlobalEdgeUsa.com.
Visit us at http://www.GlobalEdgeUsa.com

We can offer very economical price per encounter. Being a small business, has given us an edge over large businesses to provide lower prices, and personalized service. Try our Verification Process for FREE, and be amazed by our quality, prices and TAT. We truly believe that a trial of our services is all we need, to showcase our strengths in quality and reliability of our services.

Dedicated or Need Based- ASC Coding Support

2009-07-09T15:37:00.000-07:00

ASC Coding

Coding is the most crucial function in the complete ASC revenue cycle, and also is one of the most complex and demanding. Assigning appropriate codes to any encounter is a complex process with many variables involved.
With ever changing regulations and the difficulty of finding trained experienced ASC coders, outsourcing the coding function has becoming a preferred method of getting the reimbursement process started. Global Edge USA offers a complete outsourced coding solution with our team of highly-trained, experienced ASC certified coders.

Expert ASC Coders

Global Edge USA employees only experienced certified coders. All of our coders have extensive multi-specialty ASC coding experience. We maintain a stringent internal auditing process and education program in order to keep our coders sharp and verify their accuracy. We have our own network of certified experienced ASC coders focused on providing cost-effective and accurate coding for ASCs, surgical hospitals and specialty physician practices. We provide CPT codes, Modifier assignment, APC’s, ICD-9-CM volume 1, 2 & 3. We also provide HCPCS coding for single & multispecialty ASC's in accordance with AMA & CMS guidelines.
Our ASC coding process includes reading the complete operative report in its entirety. Following all guidelines set forth by CMS and AMA, the coder analyzes to ensure: (1) all possible CPT codes are captured, (2) supporting ICD-9 diagnosis codes are abstracted, (3) appropriate modifiers are applied and (4) all of this documentation is submitted for billing.

Simply fax/send us your operative notes, pathology reports, and patient schedules to receive your codes back within 24 to 48 hours. We can offer both dedicated coding analysis or as needed, we will assist your facility on a short term or as needed basis during an employee vacation, an extended employee leave of absence, staff turnover, or if you need a little help during month end, and the best part is our pricing.

Call us: 510-257-4563 Fax us: 510-257-4510 to inquire more about our services.
Email us at solutions@GlobalEdgeUsa.com.
Visit us at http://www.GlobalEdgeUsa.com

We can offer very economical price per encounter for freestanding ASC’s and are also willing to accommodate any special requests of our clients to suit their requirements. Being a small business, has given us an edge over large businesses to provide lower prices, and personalized service. Try our Coding Analysis for FREE, and be amazed by our quality, prices and TAT. We truly believe that a trial of our services is all we need, to showcase our strengths in quality and reliability of our coding services.

Account Receivable, Insurance Follow up Services

2008-08-27T12:29:00.000-07:00

Account Receivable, Insurance follow up services

Global Edge Usa, account receivables follow up services focus on low value and low margin accounts that make it difficult for you to profitably recover your revenues. We work on improving your cash flow by reducing the number of days in AR by increasing the ratio of your collections and profitability. An effective account receivables management allows our customers to improve their revenue which has great bearing on efficient operations and can impact business scalability significantly.
Global Edge Usa Accounts Receivable Services guarantees quicker payments, improved cash flow and allows your employees to concentrate on higher value added activities which also help in employee retention and motivation.

Our team of professionals receive extensive training and are well versed with billing terminology and revenue cycle. All our work is audited in house, ensuring compliance with accuracy and efficiency.

Global Edge Usa Insurance Follow up

Global Edge Usa follows a comprehensive insurance follow up process that’s provides, collectors with necessary automated tools, proper training and reporting to resolve old account receivable and generates revenue from unpaid or slow paying insurance accounts. By using an aged AR report, our trained professionals contact insurance companies directly in order to determine the status of the claims on the given outstanding claims. Global Edge Usa ensures maximization of collection and efficiency. We follow a pro-active approach keeping quality, accuracy and compliance in mind.

Some examples of servicing options include:
• Federal Insurance
• Commercial insurance Follow up
• Managed care
• Worker’s Compensation/MVA/PI

Federal Insurance
Our software and knowledge are always up to date as per Medicare guidelines. Global Edge follow up solution is focused on ensuring that insurance will always receive clean claims and to fulfill the same, maximum of the primary as well as secondary claims are being submitted electronically. We also ensure frequent use of the insurance websites for effective and timely follow up.

Commercial Insurance Follow up
We have an excellent record in handling commercial and managed care plans. To make our services more effective and faster we have enrolled our self with all big payers to use their online services for insurance verification, claims status and ERA. All major procedures are filed with authorization on behalf of the provider as per their contracts. We have thorough experience in all PPO plans like BCBS, Aetna, Humana, Cigna, Great West, AARP, GHI, United Health Care, United medical resources (UMR), First health, Mega Health, Magna Care, Secure Horizon, PacifiCare, Mutual of Omaha, Inter Plan Health and many more.

Managed Care
Managed care plans tend to delay payments, as they require a lot of documentation, authorization requests and Out Of Network (OON) processing. Our teams are highly experienced in handling issues for timely processing of claims. We also provide credentialing facilities to providers so they can get rid of ONN processing’s and gain good reimbursements.

Worker’s Compensation /Motor Vehicle Accounts/Personal Injury
This is the area where are expertise comes in, Global Edge Usa has extensive experience on WC, We have highly trained professionals who know how to get paid for these claims. We handle many big accounts which only deal with WC, personal injury and Motor Vehicle accounts, we send documentations, file liens, call attorneys and judges; send non-appearance letters, offer negotiations and settlements. For Personal Injury Accounts we perform call layers, send statements to attorneys and we do out of court settlements and continue until it’s resolved.

Our Account Receivable Service includes:

Aging Analysis – Analysis of a situation is always necessary to proceed in the right direction, and that’s exactly what we do. We run an aging summary report when we start working on a new account. At the end of the month, a new report is generated and is compared with the initial summary report to check on improvement and accordingly we work on the areas of concern.
Payer Follow up – Our team of professionals are experts in working upon federal and non-federal insurances (PPO, EPO, HMO, IPA, MVA, WC, PI, DME). Which includes Medicare, Medicaid, Tricare, BCBS, Aetna, Humana, Cigna, Great West, AARP, GHI, United Health Care, United medical resources (UMR), First health, Mega Health, Magna Care, Secure Horizon, PacifiCare, Mutual of Omaha, Inter Plan Health and many more.
Denial Trend management – We have a dedicated team which only works to define the denial trends associated with different insurance’s. This is done with the help of denial EOB’s and comments being entered in the system by the AR followers.
Reporting –A basic reporting structure has been defined into three steps –Daily reporting, weekly reporting and monthly reporting. Further this can be defined or modified as per the client’s requirement.

Software’s Expertise

Global Edge Usa has experienced and well trained specialists that are well versed with different billing software’s such as Medical Manager, e-clinical, Intergy, SurgiSource, Misys Tiger, Acer-Med, elligence, Medaxis, CPR plus, Parcs, Medisoft, MD Synergy, Advanced MD, Claim Manager, Alta Point, Manage MD, AdvantX, Nextzen, Office Ally, Kareo, CompuMed, Professional Studio, Sequel Med, Medrium, Practice Studio, Amazing Charts. We also provide a dedicated in-house training and development program that helps the staff inculcate a wider understanding of the entire process, which in turn will help them to adapt to any new software seamlessly and replicate the process.

Tools Used for AR follow up

Account Receivable Analyst uses the following tools, reports and documents to identify and investigate issues that are affecting cash flow and preventing timely and accurate reimbursement of claims by payers. One or more and sometimes all of the following tools, source documents and resources are required for a complete and effective AR follow up:
• Patient Account Ledger
• Explanation of benefits
• Regular mail or correspondences
• Account Receivable calling
• System reports like
1) Aged insurance/Aged AR Reports
2) Custom Reports
3) Financial Reports
4) Claim submission reports
5) Patient statement reports
6) User reports

ACCOUNT RECEIVABLE PROCESS

Step One – Report Execution
At the beginning of each month Account Receivable analyst runs an Aged insurance Report on the billing system using required parameters and identifies the claims that are unpaid or in appropriately paid. This report provides a list of outstanding claims pending against each insurance carrier.

Step Two – Identification of Account Receivables
From the above report, the account receivable analyst selects claims that remain unpaid beyond 30-45 days from the date of filing. The number of days depends on whether their claims were sent on paper (paper claims), or were transmitted electronically (electronic claims). Also, the number of days depends on the average turnaround time for the claims to get settled, i.e. from the date of filing of the claim to the date of receipt of payment for the claim.

Step Three – Identification of the problem –Review
Account Receivable analyst then reviews patient accounts ledgers pertaining to the unpaid claims to analyze why the claims are still outstanding. Analyst reviews patient ledger from the billing angle for possible violation of billing rule.

Step Four – Identification of the problem – Calling
If the claim has been prepared and submitted correctly as per insurance requirement, and usual turnaround time has been passed, call needs to be placed with respective insurance carriers to ascertain the status of outstanding claim.
Analyst or Account Receivable caller obtains the required information from the insurance company and documents the results of the call in the collection notes section of the patient account ledger. Based on the call notes, appropriate steps needs to be initiated to settle outstanding claims.

Step Five – Identification or execution of corrective action
Once issues or problems have been identified the Account Receivable analyst initiates action to resolve. Issues may be forwarded to one or more departments, or to the client, depending on the nature of the issue. Complete resolution of an issue may require inputs or action from more than one department.

Step Six –Identification of Un-collectible AR
Details of the outstanding claim balances that the Account receivable analyst considers uncollectible, and which may thus have to be written off, are forwarded to the client for decision-making. Details of outstanding claims, where collections efforts have failed due to non cooperation or lack of response from payers or liable parties, are also forwarded to the client.

Why Outsource Medical Billing Services Now?

2008-05-11T21:44:00.000-07:00

The importance of business process outsourcing (BPO) on every organization's bottom line cannot be ignored; however, it is imperative to base outsourcing decisions on more than just cost savings. Business strategy should also be included in the decision process.

The business rationale behind BPO is that outsourcing saves money and focuses scarce management time and resources on a few core competencies. The list of outsourced functions grows daily and includes call centers, order entry, billing and collection, human resources administration, cash and investment management, tax compliance, internal audit, and payroll.

The real reason behind the surge in BPO is that companies are becoming more demanding. Cost-cutting and improved service levels are no longer the only result expected from outsourcing. These days, CEOs are demanding value. They want to see, and have come to expect, transformational change from their outsourcing efforts - from changing how human resources is managed to changing the way the supply chain operates. The ultimate goal is to link business performance to increased business value.

In BPO, the metrics that matter are business metrics. For example, the key metric for a bank is the cost to administer a mortgage every month. In the insurance marketplace, it is the cost per beneficiary per month that matters. For health care firms, the issue is the cost per member per month. These are the crucial business metrics for which the provider is measured and rewarded.

Benefits from Outsourcing medical Billing and coding process are:

1. Cost reductions
2. Improved service quality
3. Superior competency
4. Access to leading technology
5. More freedom to focus on strategic activities
6. Increased shareholder value
7. Economy of scale
8. Shared risk

Our research tells us that the biggest cost gains and efficiency improvements from outsourcing tend to come from re-engineering organizational processes and implementing best practices.

Top 10 Reasons to Outsource Medical Billing Services now are
1. Control Costs
2. Improve operational efficiency
3. Abundance of skilled manpower
4. Lack of availability of internal resources
5. Improve speed and time-to-market
6. Optimum utilization of resources
7. Focus on core competence and innovation
8. Greater flexibility and competitiveness
9. Availability of functional expertise and domain knowledge
10. Global Best Practices

Medical Billing Outsourcing: Why should you?

2008-04-30T23:46:00.000-07:00

There are many compelling reasons why medical billing outsourcing to a professional medical billing and coding company should be a good business move. A major problem with in-house medical billing services is regarding human capital like managing, retraining, attrition and growth. Do you have the time and money for all of that? Human Resource Management is the most compelling single reason why physicians and other medical service providers outsource their medical billing to a medical billing company that specializes in providing this service.

Employee turnover and practice growth are the 2 main areas where the Human Resource problems come from.

Medical Billing Outsourcing Reduces Employee attrition:

While your practice may be lucky by having manpower that has stayed with you through the years, the fact remains that they will, eventually, leave. Others are faced with an on-going turnover problem. In either event, once a medical billing specialist leaves, you are forced to fill that vacancy right away or your revenue cycle may be impacted. That often means hiring someone with lesser …or worse yet very little medical billing experience. Inexperienced medical billing specialist make errors ... errors that can cost your practice money or seriously delay your getting paid in a timely manner. Also, who will take the time to train your new medical billing specialist? Will you spend your time doing this? Or will you pay someone else to do it? Is that a good use of your time? Even if you still have other medical billing specialists, their use in training will take away from their time normally spent in helping to get you paid in a timely manner. Medical billing outsourcing avoids these problems all together.

Many medical practices go through high turnover periods, while others find loyal people who dedicate many years to working for the same physician. The human resource management cycle can be very difficult for a physician to maintain. Once the medical billing specialist leaves, the Physician is left with no other option and is usually forced to hire another medical billing specialist who has very little experience. Ask yourself this question, when would you be the most worried; when your receptionist quits or when your medical billing specialist leaves? Do you really have the time to find a medical billing specialist who is experienced and reliable and can do the right job with the amount of attention your medical billing deserves? Medical billing outsourcing is a better solution.

Medical Billing Outsourcing Helps in Growing your Professional Practice:

As your business grows, your revenues will grow and so will the medical billing and coding workload. However, your employee costs are fixed costs, while your billings and receivables are not fixed. So, when your business has grown to the point where the workload overtaxes the current medical billing personnel, you will need to add another medical billing specialist … maybe more. That is an sudden increase in fixed costs, because now you are - in effect - overstaffed, as the volume of the workload has not as yet caught up to your newly-expanded billing capacity.

Use medical billing outsourcing to change your medical billing expenses from a fixed cost to a variable cost and improve your ability to manage your business.

When you choose medical billing outsourcing, your costs vary directly with your medical billings. If your medical billings drop, your costs drop. If your medical billings go up, your costs do not rise disproportionately. This simple fact can make your business planning easier.

Medical Billing Outsourcing helps Reduce Paperwork and Lower Employee Costs

If you do your medical billing internally, salary is typically only about 70-75% of your employee costs when you figure in payroll taxes, FICA and insurance. Not to mention that added paperwork cost of administering them. Plus, when you’re medical billing specialists are sick or on vacation, you’re still paying them for not working. When you outsource your billing by taking advantage of our professional medical billing specialists, the overhead and paperwork is ours, not yours.

· Medical Billing Specialist's Employee salary

· Medical Billing Specialist's Employee benefits

· Worker’s compensation

o FICA

o Health care insurance

o Vacation, sick leave, etc

o Performance bonus

· Computer hardware purchase & maintenance

· Software purchase & renewal

· Clearinghouse fees

· Postage & Stationery

· Physical (Office) Space

· Training and re-training

· Recruitment costs

· YOUR time & Opportunity costs

Medical Billing Outsourcing Minimizes Errors & Helps in Faster Revenue:

Insurance companies are always looking for ways to slow down paying you. It’s how they manage their cash flow. Anything that is miscoded can cause your bill to be rejected or its payment delayed significantly. When you outsource your medical billing to our medical billing specialists, you’ll not only be getting professional medical billing services, you’ll be benefiting from a degree of accuracy that would be difficult to match internally. With a Medical Billing Outsourcing setup, every submission is reviewed by a supervisor to help ensure accuracy. That “extra level of eyes” is a luxury impractical with in-house medical billing.

Medical Billing Outsourcing- What we can do?

When you take advantage of Medical Billing Outsourcing, you improve your cash flow and collections and reduce the costs and headaches of employee problems.

Let our Medical Billing Specialists show you how to keep more of the money you make. Outsourcing your medical billing services allows the money you get to grow in direct proportion to the direction your business is going.

Call us at 1-510-257-4563 or E-mail us at solutions@globaledgeusa.com

To know more visit us at http://www.globaledgeusa.com

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GlobalEdge Medical Transcription Services

2008-04-24T15:03:00.000-07:00

GlobalEdge is a medical transcription company serving transcription firms, individuals that interface directly with medical practitioners for the last 4 years. We transcribe over 1 million lines per month. Our team of qualified, experienced medical transcriptionists and editors has a minimum of 2-3 years of experience and the QA teams have atleast 5-9 years of experience, and can be relied upon to deliver cost-effective, timely service with full data security and HIPAA-compliant processes. Partnership with us will support the business growth you are looking for.

Global Edge transcription services are committed to providing quality medical transcription services to all our clients. Our medical transcriptionist's are professionals with solid backgrounds in the fields of human anatomy, disease processes, path physiology, and pharmacology, along with all relevant medical terminologies. All team members undergo extensive medical transcription training before starting to transcribe

Quality work is the foundation of our reputation. We commit to an accuracy of 98.5% plus. The transcription process and quality assurance program that we employ ensures a consistent and uncompromising level of service that Global Edge stands behind.

Global Edge Medical Transcription Services

100% HIPAA compliant in all health-care processes.
Assured data security.
Assured patient confidentiality.
Follow non-disclosure, non-compete ethics
We do a thorough background check for all employees in all domains
Well-synchronized and well-coordinated departments.

Global Edge Transcription Service offer:

We offer encrypted FTP channels for our clients to post digital audios.
Dynamic work allocation; job assignment through proprietorship-owned distribution software
Final reports are delivered simultaneously over encrypted path to Coding Division and Medical Practice/Client
Our Medical Transcriptionist's have at least 2-year experience
Our QA team members have 4-9 years experience.
We have a proven minimum accuracy of 98.5%
Proven record to meet 24-hrs TAT.
We process 1 million lines/month
Have capabilities to process reports in real time
Automated reconciliation process.
Compulsory three levels of transcription to ensure quality/accuracy

Entire team has wide exposure to all types of reports, viz:Ø

History & Physical
Operative Notes
Radiology Notes
Consultation Notes
Discharge Summaries
Medico legal Evaluations, etc.

We excel in client-related document management like:

Physician Lists
Client-Specific Guidelines
Templates
Policies

Use latest up-to-date resources physical & electronic books:

Stedman’s Medical Dictionary.
American Heritage English Dictionary
Quick Look Drug Reference

A dedicated single point of contact deals with our clients on day-to-day affairs.

GlobalEdge Transcription Services - Security and Confidentiality

At GlobalEdge transcription services, we understand the importance of protecting the confidentiality between medical professionals and their patients. Our procedures and practices are founded on providing the utmost protection to personal health information, with HIPAA as our overall guide.

Data security is equally important to us. We employ the FTP secure solution in transferring personal health information over our Web site, using 128-bit SSL (secure sockets layer) encryption or direct FTP client to your server with 256-bit encryption. This level of encryption is the strongest available and ensures that data remains secure and confidential.

Personal health data resides on the company's wired network workplace. Transcriptions are done on workstations that are not connected to floppy drives, printers or the Internet. Only identified and authorized company personnel are permitted to access personal health information in the company system.

All our employees work at controlled, continually monitored offices. Company-issued badges are inspected when employees enter the workplace. Upon their departure, all packages and personal belongings are searched to ensure that no documents ever leave our site.

Personal health information remains in the company system for two weeks after payment is rendered to GlobalEdge. After that, the data is deleted, and the client is notified of which job request data was purged from the company system.

GlobalEdge exercises a zero-tolerance policy with regards to any breach of security or confidentiality

Call us at 1-510-257-4563 or email us at

solutions@globaledgeusa.com
To know more visit us at http://www.globaledgeusa.com/medical_transcription_services/

Outsourcing Medical Billing and Coding Services

2008-04-20T03:10:00.000-07:00

At the outset we wish to thank you for giving us an opportunity to introduce Global Edge. We are a small business based in northern California, providing comprehensive billing support services to Healthcare Billing Companies nation wide. We are a responsible and truly affordable single source solution company for Medical Billers and Billing Companies, providing secure, reliable and comprehensive medical billing and coding support services. We have extensive experience with most of the billing software’s/EMR, such as like Medisoft, SequelMed, AdvantX, eClinicalWorks, Misys Tiger, SurgiSource, AdvancedMD, and Medrium.

Security, accuracy, reliability & confidentiality with excellent customer service are our underlying strength’s and our guiding principle.

Our services focus on:

§ AR follow up – with focus on legacy & low value accounts.
§ Excess, Pending, or Back logged billing support
§ Patient registration, Charge entry and Payment postings
§ Accounts reconciliation & Denial management
§ ICD-9 coding based on AMA & CMS guidelines
§ CPT, APC, DRG’s & HCPC’s coding across specialties

We truly believe that a Free Trail of our services would be all we need, to showcase our strengths in quality and reliability of our services. And so we wish to invite you to request an absolutely risk free offer to try our services with no commitments at all, and then decide whether Global Edge, is the right partner for you. Take a Test Drive. No risk. And Free. There is nothing to loose, call us today! 1-510-257-4563.

In today’s health-care environment, as a health care service provider company, you face many of the same challenges that your clients face – declining revenues, skyrocketing operation costs, increasing overheads, shortage of skilled manpower, inability to scale up your operations, high attrition rates and loads of excess back logged/ pending work. Global Edge can help! With our experience, knowledge and access to global resources; we will become a source of maximizing revenue, reducing your costs, reduce your risks and ensure a profitable future for you. Take advantage of our services, to better compete with other Medical Billing and Coding companies, who have enjoyed outsourced billing support services.

Call us at 1-510-257-4563 or email us at solutions@globaledgeusa.com
To know more visit us at http://www.globaledgeusa.com