This department of Tausch is responsible for registering the patients in the system before entering the charges. The demographic details of the patients are received from the hospitals via scanning department.

Patient Demographics & charge entry is the first step of the billing process and an error here will prompt errors in the subsequent steps. In some cases this error can be discovered only after the claims reach the insurance carriers. This will result in lost accounts receivables time. Hence utmost care should be taken while entries are being made.

The registration details involves the patients name, address, social security number, birth date, sex, rendering & referring doctors name, phone numbers, insurance company details, employer details etc, and once these details are entered into the system the treatment charges can be entered into the particular patients account.

Tausch’s professional Cash posting Service delivers account creation and payment posting service for each individual patient record and effectively lowers the overall cost of Healthcare providers. Recording and managing of cash posting service requires expert and dedicated human skills and knowledge of billing software. Our highly skilled and experienced executives post payments and adjustments received from primary insurance, secondary insurance and patients.

Claims that need resubmission are checked for all necessary documents like Medical records, Referral, Authorization etc. and reprocessed to the insurance or forwarded to the AR management team for further processing.

Aggressive follow up on submitted claims is important for quicker reimbursement. Our accounts receivable specialists follow up with insurance companies by phone, fax or through online portals etc. Denials or partial payments are analyzed appropriately, corrected and the claims are re submitted to the insurance company. Our denial/ account receivable management team receives extensive training in AR follow up and constantly updated on latest in healthcare. Aggressive follow up starts in 15 days after claim submission. Our specialist are chosen for their analytical skills and provided with access to all documentation required to make sure that the claim is resolved to be paid in the very first call. E.g; When the insurance rep says that claim requires authorization number, Our specialist are trained to immediately retrieve the authorization number from our database and fax it while they are still on the call.

As soon as we receive explanation of benefits (EOB) denied claims are worked on, rectified and resubmitted. EOB is posted on the same day and all rejections that require additional information are sent to the doctor’s office. We are well versed in using correct appeal procedure in knowing healthcare laws and we specialize in working on old account receivables.

Healthcare credentialing plays a vital role in maintaining quality and ensuring competence in the U.S. healthcare system. It involves the verification of healthcare professionals' qualifications, experience, and adherence to industry standards.

Our credentialing administrators, from the provider side do the below tasks:

1. Researching payer requirements and application process.
2. Completing the application accurately.
3. Gathering and submitting supporting documentation.
4. Following up with the payer.
5. Responding to inquiries.
6. Coordinating contract negotiation (if applicable).
7. Reviewing and signing the agreement.
8. Ensuring provider participation.
9. Maintaining accurate records.
10. Monitoring credentialing expirations.
11. Staying updated on industry changes.
12. And much more

Our medical transcription team is responsible for converting spoken medical reports, dictations, and other audio recordings into written documents. Their primary tasks include:

1. Transcribing: Listen to audio recordings and type out medical information accurately.
2. Reviewing and Editing: Ensure accuracy, grammar, punctuation, and formatting in transcribed documents.
3. Formatting and Organizing: Structure documents with appropriate headings and sections.
4. Maintaining Confidentiality: Handle patient information securely and comply with privacy regulations.
5. Researching: Conduct research to verify medical terms and procedures for accurate transcription.
6. Utilizing Technology: Use specialized software and tools to improve efficiency in transcription.
7. Knowledge of Medical Terminology: Understand medical terminology, anatomy, and procedures.
8. Time Management: Effectively manage time and meet transcription deadlines.
9. Attention to Detail: Focus on accuracy and capture all relevant information.
10. Continuous Learning: Stay updated with medical advancements and engage in professional development.
11. Communication and Collaboration: Interact with healthcare professionals for clarity and additional information.
12. Quality Assurance: Work under quality assurance programs to maintain high transcription standards.
13. Adaptability to Different Specialties: Familiarize with specialty-specific terminology and requirements.
14. Understanding of Medical Reports: Comprehend different types of medical reports and adhere to specific guidelines.
15. Ethics and Professionalism: Maintain integrity, respect patient privacy, and handle confidential information appropriately.

Our prior authorization executives are responsible for managing the process of obtaining prior authorization for medical procedures or services on behalf of patients for providers. Here's a brief summary of their role:

1. Access the Portal: Log in to the insurance company's online portal.
2. Navigate to Prior Authorization Section: Find the section dedicated to prior authorization requests.
3. Select Request Type: Choose the appropriate request type for the procedure or service.
4. Provide Patient Information: Enter patient details and insurance information.
5. Upload Documentation: Attach supporting documentation required for the request.
6. Complete Request Form: Fill out additional forms and provide necessary information.
7. Review and Submit: Double-check the information and submit the request.
8. Confirmation and Tracking: Note any confirmation details provided and track the request's progress.
9. Follow-up and Communication: Respond promptly to any updates or requests for additional information.
10. Notify Healthcare Provider: Inform the provider of the decision received and take appropriate action.

Our medical patient appointments scheduling team is responsible for arranging and managing healthcare appointments. It involves coordinating provider availability, assigning suitable time slots, and ensuring clear communication with patients. The goal is to enable timely access to care and enhance the patient experience. Their primary tasks include:

Scheduling: Coordinate patient appointments based on availability and urgency.

Communication: Serve as a primary point of contact for patients, providing information and instructions.

Coordination: Manage multiple providers' schedules and ensure a smooth scheduling process.

Patient Support: Assist patients in understanding procedures and address concerns.

Record-keeping: Maintain accurate records of appointments, cancellations, and updates.

Appointment Confirmation: Confirm appointments with patients to reduce no-shows.

Resolving Scheduling Conflicts: Address conflicts and find suitable solutions.

Prioritization: Determine appointment priorities based on urgency and medical necessity.

Collaborating with Insurance: Verify insurance information and coordinate coverage details.

Managing Waiting Lists: Maintain waiting lists and notify patients when slots become available.

Appointment Reminders: Provide reminders to patients to reduce missed appointments.

Adapting to Changes: Quickly adjust schedules and communicate changes effectively.

Utilizing Scheduling Software: Proficiently use software and EHR systems for appointment management.

1. Medical coding involves assigning standardized codes to medical diagnoses, procedures, and services.
2. A medical coder reviews medical records to extract relevant information for coding purposes.
3. The coder assigns appropriate codes to represent the diagnoses, procedures, and services documented in the medical records.
4. Accuracy is crucial in coding to ensure proper reimbursement and compliance with codingguidelines.
5. Medical coders need a comprehensive understanding of medical terminology, anatomy,physiology, and disease processes.
6. Coders stay updated with coding changes and regulations through ongoing education.
7. Medical coders often collaborate with healthcare professionals to clarify documentation and gather necessary information.
8. Compliance with coding rules and regulations is a key responsibility of medical coders.
9. Coders may participate in coding audits to review accuracy and identify errors.
10. Accurate coding supports proper billing, reimbursement, compliance, and data analysis in healthcare.