HealthCare & Life sciences

Health Care Overview

Are you having trouble keeping your Accounts Receivable (A/R) days under control? Is a lack of skilled resources leading to a backlog of claims that need to be processed? With ICD-10, the potential for the number of denials is certain to go up if you are not prepared. It is critical to success to have access to a large pool of qualified resources that work in any Practice Management System and understand how to quickly and correctly analyze account history, appeal denied claims, and get timely turnaround to recover on and close out A/R. Analysts who trend denials and look for patterns of deficiency will increase cash flow and reduce aging A/R.

Medical Coding

Medical coding is a form of translation in which every aspect of a patient’s care is documented so it can be properly billed. Numeric or alphanumeric coding is used in lieu of traditional documentation to accurately catalog the unique reasons for each patient’s visit to a clinic or hospital. This includes the reason for the visit, the diagnosis, any tests that may have been requisitioned and any medications prescribed.

Each aspect of the visit has its own code, and these codes are all organized in a specific way to create a succinct record of the patient’s visit. There are three types of codes generally used for medical coding

ICD: The International Classification of Diseases (ICD) code is used to describe the causes of the patient’s injury, illness or death. Established by the World Health Organization (WHO) in the 1940s, the ICD code is updated often, which is why it’s followed by a numeral — that numeral indicates the version of the code. For example, ICD-10 is the 10th version of the code. The codes are then further given clinical modifications, which help expand the number of illnesses, injuries and causes of death to provide even more specific documentation.

CPT: The Current Procedure Terminology (CPT) code is used to document the medical procedures the patient receives during their clinical visit. These codes are divided into three categories. The first category is further divided into sub-categories of numeric codes, which correlate to specific medical fields, such as radiology, surgery and anesthesia. The second category consists of alphanumeric codes to identify performance measurement as well as potential laboratory or radiology test results. The final category of codes is related to up and coming medical technology.

HCPCS: The Healthcare Common Procedure Coding System (HSCPC) is similar to CPT codes and is used to record medical services, equipment or procedures not covered by CPT coding. It’s also the official coding system for Medicare and Medicaid, making it one of the most important codes for a medical coder to know.

All these codes need to correctly and accurately correspond to a medical service or procedure. Any incorrect claim can lead to claim denial, which is why it’s extremely important to ensure medical coders are well-versed in the coding procedures.

Why Us?

We Provides Medical Coding Services to Hospitals and Speciality Physicians with timely, high Quality Medical Coding Solutions. Our core competency lies in providing high quality medical coding services for all medical specialties and subspecialties. By partnering in Remote Medical Coding services with us.
You get:

  •  Expert, certified coders that is specific and dedicated to your needs and practice
  •  A process that is tailored to each client’s policies and protocols
  •  A process to identify documentation issues and how to avoid them
  •  Optimized revenue while reducing compliance risk
  •  Increase cash flow by reducing lag days and improving claims submission
  •  Reduced administrative burden and expenses
  •  Workflow management system that supports the coding process and tracks every record, code and status

Compliance

The key to our business in every department. We strictly complies with HIPAA. Every employee is trained to adhere to stringent security procedures and guidelines to protect the data entrusted to us and handle your medical record coding with the utmost in confidentiality and security.

We are committed to providing accurate, aggressive and ethical coding, that is compliant under government and insurance regulations. In short, our medical coding specialists work to ensure your maximum reimbursement, without leaving you subject to audit.

Vainqueur expertise in healthcare documentation, compliance standards, coding capabilities and our investments in skills up-gradation of our resources have established us as the preferred service provider for marquee clients.

Key highlights of our Coding Centre of Excellence are:
  •  We, AAPC and AHIMA certified coding team is proficient with CPT, ICD, HCPCS level II and DRG codes across various specialties.
  •  The coders complete a comprehensive training program and are involved in continuing education programs.
  •  Assurance in maintaining coding policies and procedures, appropriate and accurate managed contract advice and reports.

Specialities

We pool of highly skilled Medical Coders has worked on multi-speciality and multi-disciplinary requirements. The following are some specialities that we have worked with although we are not limited to these specialities:

  •  Inpatient Coding
  •  Ambulatory Surgery Coding
  •  OPV Coding
  •  Emergency Room Coding
  •  Medical coding audits Consulting

Quality Control

Files are audited by a certified senior coding staff who checks on the accuracy of the codes assigned. Our quality assurance team verifies that the charts for up-coding or down-coding will ensure maximum reimbursement and fewer or no denials. WHY US?

  •  Best in class, comprehensive QA process – with an emphasis on accuracy – to measure and assess individual coder performance and overall coding quality
  •  Rework Denials at our expense
  •  Prompt, Efficient and 24/7 support
Facility Coding

– Inpatient; Same Day Surgeries; Observations/ Outpatient Services; Ancillaries; Rehab; Emergency Departments; Hospital-based.

Physician Coding
  •  Diagnostic Procedural/ Surgical Services; E&M (including Office Visits, Preventative Visits, Observations, Inpatient Services Consultations and Emergency Services)
  •  Clinics; Facility E&M
  •  Proficient with Leading HIT and HIM Documentation Systems
  •  Extension – Not Outsourcing – Of Coding Processes
  •  On-site & off-shore virtualization of operational processes
  •  Comprehensive extension of client’s process adapted to their priorities, policies and protocols
  •  Workflow management system that supports the coding process and tracks every record
  •  Named, dedicated resources assigned to your account
Client Friendly Terms & Conditions
  •  Unbeatable, flexible, simplified – per case or per FTE – pricing structure
  •  Currently serving a US-based top 5 HIM Solutions company since 3 year
  •  Fully Compliant with HIPAA Privacy and Security regulations
  •  Coding completed in Client HIM systems via a secure VPN and SSL connection
  •  Paperless Coding Production Centre
  •  Facility Coding: Overall Coding Accuracy Rate: Over 98
  •  Physician Coding: Overall Coding Accuracy Rate: Over 98%
Increase Medical Coding Accuracy

Improve your coding accuracy
To increase reimbursement and reduce compliance and audit risks.
Identify the specific errors or disconnects
That result in a denied claim by reviewing, monitoring, and tracking each medical claim.

Gain insights

About your organization’s coding and clinical documentation performance by assessing processes and performance by provider and department.

Leverage technical and professional staffing services

For contract, hourly, temporary, or permanent positions, as well as direct hires.

Use our flexible coding services

In any care setting and for any duration. We can help you improve coding accuracy with ongoing, periodic, or one-time coding assistance.

Depend On Our Medical Coding Expertise

Optimize revenue with qualified, experienced coders

  •  Hands on medical coding services can help you improve accuracy with ongoing periodic, or one-time coding assistance across all medical specialities and care setting for hospital and physician practices.
  •  Our onsite and remote coding services address specific coding are as including inpatient, outpatient, emergency department, ambulatory care, surgery centres and provider-based billing locations.
Improve coding accuracy with certified staff

Vcs provide technical and professional staffing services for contract. Hourly. Temporary or permanent position as well as direct hires. Our coding professionals will review, monitor and track each medical claim to identify the disconnects that create errors. With our Health Information Management (HIM) staffing services, we assist in the implementation of new programs, review and optimize existing operations, and offer training, education, and staffing support.

Onsite or virtual training and education helps address coding and documentation deficiencies. We can help your staff document more effectively and code more accurately to ensure you receive reimbursement for all services rendered.

Healthcare Accounts Receivable (A/R) Management

Are you having trouble keeping your Accounts Receivable (A/R) days under control? Is a lack of skilled resources leading to a backlog of claims that need to be processed? With ICD-10, the potential for the number of denials is certain to go up if you are not prepared. It is critical to success to have access to a large pool of qualified resources that work in any Practice Management System and understand how to quickly and correctly analyse account history, appeal denied claims, and get timely turnaround to recover on and close out A/R. Analysts who trend denials and look for patterns of deficiency will increase cash flow and reduce aging A/R.

We can lower internal costs, increase collections, and improve your cash flow. We specialize in enhancing the financial performance of our clients by seamlessly supporting Revenue Cycle Management (RCM) and related processes. As a partner to our clients, our serves as a direct RCM extension to Hospitals and Physician Practices by leveraging healthcare expertise, technology and qualified resources.

We provides access to a scalable and large pool of resources experienced in multiple Practice Management Systems to increase your collections ratio. Our sophisticated A/R workflow tool seamlessly performs skill-based routing. It also generates customized intelligent reports that help quickly identify and resolve unpaid accounts. Our skilled staff is trained to identify patient accounts that require follow-up and take the necessary action to collect unpaid/underpaid claims.

Don’t leave money on the table. Up to 70% of your denied claims can be recovered. The Our A/R team can see your denied claims are recovered. We are known for high performance in the following:

Clearinghouse Rejections
  •  Rejections are resolved within 48 hours
No-Response Follow-Up
  •  Perform status checks on higher dollar balances and identify issues proactively to reduce aging and maintain an untouched ratio of under 3% of the overall inventory
Denial Management
  •  Address all denials within 7 days

Revenue Cycle Management

RCM is an integrated end-to-end solution to manage all aspects of Revenue Cycle Management

  •  Supports multi-specialty capabilities
  •  Leverages proprietary technology & analytics led framework
  •  Offers KPI driven performance management

End-to-End RCM Solutions

Vainqueur provides end-to-end, comprehensive Revenue Cycle Management solutions from payor credentialing to complete billing and collections services. With 12+ years of RCM experience, our billing experts are well versed in all Medicaid state plans, managed care plans, government-funded programs, third-party insurance, and Medicare billing rules. We follow industry-standard key performance metrics to measure success and integrate best practices, so that you get the value of our proven experience and expertise.The Solution includes:

  •  PMS/EMR System and RCM Process Implementation
  •  Scheduling, Eligibility Verification, and Pre-Authorization
  •  Medical Coding
  •  Claims Submission (Use your clearinghouse or a partner of ours)
  •  Accounts Receivable (A/R) Management
  •  Credit Balance Resolution
  •  Customer/Patient Access Solutions

Multi-Specialty Capabilities

Our multi-specialty RCM capabilities span across both surgical and non-surgical specialties. We provide a clinically driven RCM model that creates a unique solution set for our clients, irrespective of the specialties they operate in. Given below is a list of some of the specialties for which we provide RCM solutions for our clients:

  •  Anesthesia
  •  Emergency Department
  •  Hospitalists
  •  Internal Medicine
  •  Neurology
  •  Ob-Gyn
  •  Orthopedics
  •  Pathology
  •  Pediatrics
  •  Pulmonology
  •  Radiology
  •  Surgery
  •  Telehealth
  •  Urgent Care
  •  Urology

KPI Driven Performance Management

Our analytics based operational model optimizes people, process and technology to transform our client’s businesses. Significant emphasis is given to denial prevention, eligibility verification and search, medical necessity checks, documentation improvement and aggressive inventory management to reduce leakage and reduce bad debt expense. Our engagements are KPI (Key Performance Indicators) driven and focus on the following:

  •  Identify Current baseline
  •  Create practice specific KPIs and benchmarks
  •  Implement quarterly KPI targets

Patient Access

Vaniqueur provides end-to-end Patient Access services, including Appointment Scheduling, Eligibility Verification, Pre-Authorization and Financial Counseling. Vaniqueur’ analytics focus on and help identify the most productive opportunities to collect co-pays, co-insurance, deductibles and self-pay amounts during each stage of the revenue cycle.

Billing and Claims Management

During the assessment phase, Vaniqueur benchmarks the clean claim and first pass rates and compare against industry Best Practices. An audit of claims failing to pass the bill editor software will be conducted. Based on the result, Vaniqueur identifies Root Causes and works with the appropriate teams (e.g. Patient Access, Coding or IT) to implement the required changes and bring the metrics within an acceptable range. Vaniqueur’ services are focused on ensuring that claims contain complete, accurate data that results in timely, optimal payment. By applying a series of interrelated steps, including patient demographic validation, insurance mapping, and insurer-specific edits applied to diagnosis and procedure codes, we optimize our clients’ cash flows.

Account Receivable Management

Vaniqueur provides Account Receivable Management services for physicians that significantly advance the timing and amount of collections. Our team of highly qualified A/R professionals will apply tailored approaches to the accounts receivable based on age, insurance type and dollar threshold to accelerate collections. With our open technology platform for Accounts Receivable Management, Vaniqueur seamlessly transitions clients’ accounts with no impact to cash flow.

Denial Management & Analytics

Vaniqueur Denial Management services include: structured workflows to classify and work denials; applications tailored to specific denials; analytics to trend denial patterns and appeals success; and feedback loops to correct upstream processes and edits to eliminate denials in the future. As allowance information is processed, we evaluate the denials and perform a root cause analysis to identify the source. We implement solid policies and procedures for the Denial Management team to track trend and communicate issues with a focus on the front and back end staff education as well as system adjustments as needed to assist in denial reduction and prevention.

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