Medical Billing & Coding ::

Revenue Cycle Management
We offer cost-effective, end-to-end Billing Support Services to third-party medical billing companies. Our Solution Suite consists of:
     • Medical Coding Solution Suite
     • Charge Entry Solution Suite
     • Cash Post Solution Suite
     • A/R Follow-up Solution Suite
 

Our end-to-end RCM Solution Suite offers you the following features and benefits:

1. Electronically Scanned Documents:
Documents are scanned in your offices and are seamlessly and securely accessed by our offshore center using fully secured VPN connections.

2. Verify and Validate accompanied documents:
Documents are split into batches and reviewed for completeness, quality and readability.

3. Accurate Coding:
Diagnosis, Procedure Codes and modifiers are assigned as per your descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code).

4. We use the following industry coding standards:

• Diagnosis Codes (ICD-9: International Classification of Disease)
• Procedure Codes (CPT-4: Current Procedural Terminology)
• Coding for Inpatient Services (ICD-9)
• Drug Codes (NDC: National Drug Codes)
• Dental Procedure Codes (CDT: Current Dental Terminology)
• Other Procedure Codes (HCPCS: Healthcare Procedure Coding System)

5. Diligent Auditing:
Six Sigma oriented Quality Control department audits the coded charge sheets.

6. Process Patient Demographics Information:
Our team members process, verify and validate demographic information of patient.

7. Claim Submission:
Claims to be submitted to the payer electronically using a clearinghouse.

8. Denied Claims Processing:
Denied claims are processed, analyzed, corrected, updated and prepared for re-submission.

9. Extensive AR Analysis:
Experienced AR Analysts run insurance reports and identify claims over 30 days.

10. EOB Processing and Payment Posting:
Insurance payments are posted to the patient accounts from EOBs into the billing agencies' existing software package.

11. Reporting:
Regular reporting enables billing agency to closely monitor performance and provide feedback to improve the process.

Medical Coding

Octagon’s Coding Centre of Excellence offers high quality medical coding services to healthcare providers and hospitals across US. With several years of expertise on both physician and reimbursement sides, our highly dedicated team of CPC and CPC-H outpatient facility certified coders from American Academy of Professional Coders (AAPC) ensure highly accurate as well as compliant coding services. We have two certified PMCC trainers on board who oversees our Coding departments and who bring in a lot of expertise in the area of Medical Coding.

Some of the key highlights of our Coding Centre of Excellence are:

• Octagon’s AAPC certified coding team is proficient with CPT, ICD-9, HCPCS level II and DRG codes across various specialties.
• Coding in accordance with NCCI (National Correct Coding Initiatives) and LCD (Local coverage decision and medical policies) as per set rules for different states across US
• Trained and Monitored by PMCC certified Trainers
• The coders complete a comprehensive training program and are involved in continuing education programs.
• Quality and Compliance continually monitored via a Corporate Quality Assurance Program and a Corporate Compliance Program.
• Minimum accuracy deliverables of over 95% and above on both CPT and ICD components.
• Octagon provides 24 to 48 hour turn-around of all completed source documents
• Confidence in coding policies and procedures, and appropriate and accurate managed contract advice and reports

Octagon's coding teams, led by MD physicians ensures continuous updates to clients, to keep up with the minimum documentation standards to allow Octagon to bill for maximum accurate reimbursements for services rendered by them. Octagon provides regular feedback to its clients on changes in code selections affecting reimbursements and front-office documentation practices to be followed as per CMS guidelines for appropriate reimbursements to physicians as well as insights into coding related denial analysis. Our expertise in E/M Evaluation & Management Services have driven clients across US to use our services for physician education, coding audits done by other billing companies and/ or physicians themselves.

Charge / Demographics Entry

Our Medical Billing Charge Entry Service gets you Claims and Demographics entered in your billing system rapidly and accurately. Through the creative combination of advanced technology and qualified and experienced billing professionals, can get the claims sent to payers faster, with less errors and at lower costs. A completely seamless solution that minimizes data-entry while utilizing your guidelines and billing software.

Some of the key highlights from our Charge Entry Solution Suite:

• Patient Registration
• Multi-specialty charge entry by our experienced billing professionals
• Verification of all claims before submission for fewer denials and underpayments
• Save up to 40% as compared to your existing costs.
• Complete HIPAA Compliant process and remote access solution keeps data in your control.
• Rapid and seamless transition to Octagon's Operations Center in India in 30 days or less

Key Benefits

• Improved cash-flow
• Faster Payments
• Higher Customer Satisfaction

Easily handle new clients without adding staff or new infrastructure.

Cash Posting

Our Cash Post Solution Suite Service gets all your payments posted accurately and usually within 1 business day. Through the creative combination of advanced technology with qualified and experienced billing professionals, Octagon can get all your payments posted in your billing system accurately and at lower cost. Some of the key highlights from our Cash Post Solution Suite:

• Experienced billing professional post payments from EOBs, Charge Slips and other documentation.
• Secondary payer billing
• Management and Posting of Denials
• Write-offs and Adjustments processing
• Correspondence processing
• Verification of all payments posted to reduce errors and ease reconciliation.
• Save up to 40% as compared to your existing costs.

A/R Follow-up

Our Accounts Receivable Follow-up Service gets you paid more, faster, and for a lower Cost. Through the creative combination of advanced technology and qualified and experienced billing professionals, Octagon can improve your cash-flow and reduce your days in A/R.

Some of the key highlights from our A/R Follow-Up Solution Suite:

• Receivable Analysis
• low per claim processing fee
• Payer Follow-up
• Denials Management
• Resubmission of Claims
• Secondary Claims Submission
• Detail Reporting