CLINICAL & ADMINISTRATIVE

The management of all the non-clinical functions involved in operating a healthcare facility like Authorization Processing & Tracking, Fax Management, Records Review etc.

New patient coordinator is the one who receives referrals and obtains necessary patient information needed for patients to be scheduled and to be treated in the facility/clinic.
They register new patients in PMS and/or update existing patient’s information. They also do medical history taking via phone or via an intake form that the patient needs to fill out.
They also make sure that patient’s information is updated, organized, and accurate.

An insurance check to determine if the patient’s insurance will cover the services to be rendered by the physician.

Why is this done?

Insurance companies regularly make policy changes and updates to their health plans. Therefore, it is important
for the provider to verify if the patient is covered under the new plan to get maximum reimbursement.

How is this done?

  • By checking the website of the insurance
  • Calling a representative of the insurance carrier

Remote staff prepares a brief written summary of patient’s medical records to discover patterns to help doctors make decisions about the patient’s medical care.

Medical Transcription

Transcriptionists listen to the recording and convert it into text and/or input the information directly to the clinic’s EHR.

Visit Note Scrubbing

Document specialists ensure that all relevant documentation required are completed prior to submission of authorization requests.

  • Common types of calls received:

    • Appointment-related calls (schedule, reschedule, cancel, confirm)
    • Medical records request and follow-up
    • Checking for authorization status
    • Medication-related calls (refill requests, prescription
      and medication concerns)
    • Patient complaints
    • Patient inquiries
  • Common types of calls made:

    • Appointment notification and confirmation
    • Checking on the status of a referral
    • Checking on the status of an
      authorization request
    • Patient information verification
  • Fax Management

    • The remote staff retrieves all incoming faxes for sorting, enters necessary patient details and document information, and forwards them to staff when indicated. Also, the remote staff can retrieve all failed faxes and makes sure that they are being sent out successfully.
  • Documents Management

    • Documents are scanned by the onsite team and are saved in storage software. Remote staff would download these documents, sort and categorize them, and attach them to the respective patient charts in the EHR.

With the Authorization Tracking service, we acquire authorization from insurance companies so that providers can provide care to the patients.

This service can help providers:

  • Track the scheduled appointments and ensure that the authorization is recorded in the patient’s chart
  • Send an authorization request before the scheduled appointment
  • Check the authorization details daily to ensure that the necessary documents are ready for the see appointment date

The referral tracking service ensures that the clinic’s incoming and outgoing referrals are recorded, organized, and authorized on time.

New patient coordinators would keep track of all incoming referrals(referrals from other providers to their practice).

The referral tracking service helps to keep track of the updates of the status of the referrals being made to other providers with the help of a tracker 

An APPEAL is a request for the health insurance company to review a decision that denies a benefit or payment for a requested service/treatment.

The remote staff prepares the appeal letter to be sent to the insurance company for reconsideration of the denied requested treatment.