Delivering quality healthcare depends on capturing accurate and timely medical data. Physicians can depend on our well trained and reliable medical coders. Our medical coding professionals possess a thorough understanding of the health record’s content and can find information to support or provide specificity for coding. MHS medical coding professionals work in a variety of healthcare settings, including inpatient and outpatient healthcare settings. 

• Knowledge of insurance claim and regulatory considerations: New patient interview and check-in procedures; established patient return visits; post-clinical check-out; computerized practice procedure methods.

• Completing cms-1500 and commercial claims: Billing guidelines for inpatient medical, in/out patient global surgery, minor surgery, and maintenance of a provider’s claim files; setting up a filing system for completed claims; determining primary and secondary status; completing common types of claims.

• Knowledge of Blue Cross and Blue Shield plans: Features of BCBS plans; correct filing procedure; completing a BCBS claim form.

• Knowledge of Medicare: Parts of the Medicare program; eligibility criteria; fee schedule; supplemental plans and managed care; filling out an HCFA 1500 claim form.

• Knowledge of Medicaid: Services covered under the federal portion of Medicaid; eligibility; services provided and paid for by state coverage; obtaining preauthorization for services.

• Tricare and worker’s compensation: Healthcare for the military; deductibles, cost sharing and eligibility requirements for TRICARE; filing TRICARE claim forms; workers’ compensation programs; classifying on-the-job injuries; preparing a First Report of Inquiry form; qualifying for workers compensation benefits.

• lcd-9-cm coding: Using the ICD-9-CM coding system; Primary vs Principal diagnosis; ICD-9-CM terms, marks, abbreviations and symbols; index tables.

• Cpt coding: Basic format of CPT service and procedure codes on the CMS-1500 claim; comparing CPT with ICD-9-CM coding; modifiers; new vs established patient; assigning emergency department and critical care codes; consultation vs confirmatory visit; preventive medicine visits.

• Hcps coding and CMS reimbursement: The HCPCS system for reporting professional services, procedures, supplies and equipment; HCPCS level II coding system; CMS reimbursement; rules of the Medicare physician fee schedule payment system.

• Coding for medical necessity: Assessment and coding from patient medical records; securing the correct physician documentation; coding an operative report; selecting and coding diagnoses and procedures from case studies and sample records.

MHS is a medical transcription service provider company which also has an overseas office in India. We are one of the most sought after medical transcription service companies providing transcription services and solutions to healthcare providers across North America. MHS EMPS assists various physicians, hospitals, clinics and several healthcare centers in providing accurate medical transcription services at a fast turnaround time and at an unbelievably low cost of just 40% of the local US rates.

• Accurately transcribes the patient-identifying information such as name and Medical Record or Social Security Number

• Transcribes accurately, utilizing correct punctuation, grammar and spelling, and edits for inconsistencies

• Maintains/consults references for medical procedures and terminology

• Follows up on physician’s missing and / or late dictation, returns printed or electronic report in a timely fashion

• Performs quality assurance check

• Each transcriptionist compulsorily undergoes training in medical terms and vocabulary

• Transcriptionist sign indemnity agreement prior to joining work at MHS to ensure utmost security with the medical data

• A specific set of transcriptionist is engaged for a particular speciality

Our EMR data entry specialists enter the clinical exam notes ito the appropriate place in the EMR, relieving the doctor of data-entry responsibilities. This helps physicians interact more with patients, because we handle the technology. As per statistics, with many medical groups, the most effective means of achieving 100% adoption is to have the more resistant caregivers use scribes. A provider can log into the system to check the accuracy of clinical notes. 

The turnaround time is between 24 to 48 hours depending on complexity and volume of the reports.

It works in 3 simple steps – 

• You record voice files with clinical notes on a Toll free number that we provide

• Our transcribers convert voices files to text

• Our EMR Data Entry Specialists remotely log into your computer and enter the transcribed notes in the EMR

Problem/Opportunity: Most Healthy Systems lose between 3% and 5% of net revenues as a result of payment denials

Solution: Outsource your denied claims to MHS, we will assist you in capturing lost revenue. We offer the most comprehensive claim review process in the industry. At MHS, we have developed an impressive electronic claim process unique to  every claim problem. Our inside knowledge of the industry has been successfully proven to overturn even the toughest denied claims. 

Benefits:

• Advanced processes in identifying and capturing additional revenue for our clients

• MHS process claims and appeals for all payer types including contractual, indemnity, government, self-funded, etc..

• MHS has the most comprehensive claims review process in the industry

• MHS knows and understands the complexities of the administrative appeals process

• Services do not cost anything until we are successful at getting your claim paid. MHS works on a “No Recovery No Cost” basis

Value Proposition

MHS Denials Analysis provides valuable information:

• Invalid Denials

• Avoidable Denials

• Underpayments

• Operational Savings

• Collectible Fees

• Missed Revenue Opportunities and Positive Edits

• Reasonable and Customary Charges

MHS Denials Analysis includes:

• Recommendations

• Holds Payers and Vendors Accountable

• Performance Evaluation – Administrative and Outsource Performance

• MHS Net Impact to the Practice (Revenue Improvement Ranges from 7% – 28% based on Speciality and Practice)

A vital part of the medical billing process is the scrutiny and verification of the patient’s eligibility and benefits before and after the treatment.

At MHS we check with the insurance company regarding any payment responsibility the patient needs to fulfill prior or post the treatment. Our teams of expert telecallers carry out this verification process two days before the patient’s appointment date.

The details that the MHS team verfies include:

• Effective date and coverage details

• Type of plan

• Payable benefits

• Co-pay

• Deductibles

• Co-insurance

• Claims mailing address

• Referrals & pre-authorizations

• Pre-existing clause

• Life time maximum

• Other related information

This information is collected and verified before the patient appointment date as it helps in getting referrals, prior authorization numbers, and optimizing the billing process, as well as preventing denials due to invalid benefits and eligibility reasons.