Today’s era can be defined as the “era of Data Analytics” especially in the healthcare industry as it can help to explore many areas and make a big impact on economic growth, create opportunities and improve efficiency in the health care business. Data analytics provides an in-depth analysis and emphasizes its usage to help look at the past to improve upon its services in the future, however, a positive impact can only be gained, if it is analyzed and utilized properly. We at KG Invicta Services use Data Analytics as a resourceful tool to analyze complex and challenging data and provide solutions to our clients using trends, specialty preferences, and other useful information. Our business intelligence algorithms and data mining help to provide an approach to reach a conclusion to our clients.
Accounts Receivable Management
An effective Accounts Receivable Management system helps healthcare organizations to keep a close watch on payment trends/budgets, open AR, and payer denial trends. KG Invicta Services will keep you informed and will provide options to pull various reports to plot and identify the actual pending AR, improvements for any payer denial trends which will eventually help an organization to improvise reimbursement rates. KG Invicta Services provides a solid solution to your pending AR and resolves them by identifying the root cause of the issue and converting them into cash.
- Our skilled multi-tasking resources utilize available options to complete a timely review of claims submitted. Including, but not limited to, utilizing the insurance IVR, checking status/appealing and/or initiating review via Insurance Websites, handling of Denial Correspondence, reviewing not only the status documented but previous follow-up history to assist in the resolution of a claim that may need escalation. We ensure limited touches on claims, avoid duplication, and a strong/aggressive follow-up tactic that will assist us in addressing more volumes and increasing your cash flow.
- Our expert AR Resources handle and address Old aged and High $ AR claims as a priority, bring down days in receivable, and ensure timely payment.
- Our aggressive intense professional approach on appeals, including but not limited to, providing clear documentation to support claim appeal is impeccable, which in turn, helped us resolving the most complex claims within your organization.
- Our internal system keeps a close watch on Insurance appeal and submission deadlines and alerts us in avoiding dead claims. All the time that goes into one claim from the time a patient presents for services to the time the claim is paid is worth every effort to deliver results on every claim payment for your organization without delay.
Aged Accounts Receivables Recovery
The process of collecting the OLD AR due to either new system migration or inefficient follow-up by current staff and/or vendor. This is a complex process, which requires an aggressive team with excellent analytical skills, in-depth knowledge in insurance guidelines/procedures, and specialized in current procedural terminologies.
We provide a comprehensive and tailor-made service to clients in recovering OLD accounts receivables using our expert team. Our unique approach starts from.
- Access to PMS and AR Reports: Getting access to client’s Practice Management System and run the required reports to identify and set goals on collections.
- Analyzing: Review the AR report and trend the pending AR by AR aging, Payer, provider and High $ Value to assist in project management
- Claims Prioritization and work Allocation: Plug in Timely Filing Guidelines to existing claims to better assist in recovery of claims while prioritizing claims that may be close to those limits in-order to focus on claims which is nearing filing deadlines. Allocation of work in bulk to address claims got affected for global reasons and for speedy recovery.
- Identifying Collectable and uncollectable: Separate collectable and uncollectable AR for clear focus to ensure our staff is spending time working claims that can be recovered while discussing a plan with the client on possible claims that cannot be reimbursed by payer due to past appeal and filing deadline, non-payable codes and exclusive guidelines from the payers.
- Setting Follow-up Date: Setting follow-up date for subsequent follow-up and identifying alternate phone number for unable to reach payers.
- Regular Reviews for transparency: Sharing daily reports and review the progress with client in a weekly basis and provide transparency.
- Patient Statement Generation: Billing patient/member for claims they are responsible for and send required statement for self-pay collections.
- Posting Payments: Posting Payment on request for claims that are paid and share the recovery progress report with the clients. Automating processes within the system to ensure timely patient collections.
The process of posting payments in client practice management system based on the Explanation of Benefits [EOB], EDI errors and Payment Checks received either from insurances and/or patients. We at KG Invicta Services have a strong payment posting background with over 20 years of experience working with leading Practice Management Systems, which reduces training times. We not only will post payments, allocate funds accurately, clean up your clearing house but we will also provide reporting and analysis in areas of improvement within your billing system to reduce turn-around in payment allocation. If necessary, we have adopted some practice within our company to contact carriers that may not have a clear path in posting to resolve any unapplied funds and/or initiate credit recoveries based on client approvals.
Patient Billing and Collections
The final phase of the billing process is ensuring bills get paid and then following up with patients whose bills are delinquent and get them recovered. Given the rise in high-deductible health plans, along with decreasing payer reimbursement, patients are being held increasingly responsible for larger portions of their healthcare bills. In turn, healthcare organizations are realizing the importance of a strong patient collections effort. We atKG Invicta Services strictly follow through the best practices of
- Developing a proactive strategy by:
- Monitoring collections
- Communication with patients to be on the same page
- Training internal staff on handling patient calls
- Up to date with Insurance updates
- Implementing payment plans and offering incentives
- Tracking performance to ensure providers get their bills settled at the earliest
- “Skip tracing” process to locate unreachable patients and ensure they are receiving undeliverable mails
KG Invicta Services
we are committed to improving the quality of patient care in the healthcare industry today.