Case Study on Medical Billing

Flatworld Solutions handled the complete medical billing process for a large medical billing organization situated in the US. We were able to improve their productivity by 30% and bring down their error rates below 2%.

The Customer

Our customer is a renowned medical billing organization who wanted to outsource charge entry and patient demographics.

The Challenge

We were initially asked to manage the patient’s charge entry and demographic functions. Since our customer was new to outsourcing, they were extremely concerned about quality. Their current medical billing team had an error rate of 4%.

When the customer outsourced their work to us, they wanted us to maintain an error rate of 2%, even though we had very less training. Our team also had to be trained on using the software and the methodology used by the customer.

We also had to ensure that the transition from onshore to offshore was smooth with the least amount of change and with no reduction in the productivity.

The Solution

At first, we provided the customer with a dedicated employee to manage their patient demographics and charge entry for 7-8 files every month. By the second month, we were able to process more than 150 files with an error rate of below 2%.

The team at Flatworld replicated the customer’s onshore process to ensure that there was a smooth transition of operations from onshore to offshore. We also provided the customer with a QA team of more than 3 years of experience in payment posting. This QA team audited all the charge sheets and processed files.

Reporting

We sent the customer regular status reports with details about the number of files in processing and the reasons for the delays. The Flatworld team also sent the customer daily consolidated reports such as:

• Feedback implementation reports
• Reports on denials and payment posting
• Revenue status reports for payments

The Results

The customer was extremely satisfied with our work and made a decision to outsource the entire medical billing processes to us, such as insurance calling, charge entry, patient demographics, patient calling and payment posting. The Flatworld team is now successfully handling all the medical billing functions of this customer. We now have over 50 full time employees working on this project. We now process over a million files on a monthly basis with an error rate of less than 2%.