Healthcare Capabilities

InfiniteBPO Healthcare Services Offerings

InfiniteBPO is one of the experienced organisations in Hyderabad, India, providing US Healthcare Services covering the entire spectrum of Payer as well as Provider Services. The resources engaged in providing the high quality services, are qualified professionals with high levels of knowledge and rich experience, certified by various schools of knowledge such as AAPC (American Academy of Professional Coders) and American Health Information Management Association (AHIMA).

Our core area of expertise is Practice Management Services. InfiniteBPO has vast multi-speciality coding experience (Radiology, OBGYN, Neurology, Cardiology, Anaesthesia, Orthopaedics, and Gastroenterology etc) with 0.2% error rate. Our Medical Coding Team is specialized in retrieving and going through patient’s medical records / history and coding the accurate HCPCS / CPT / ICD9 codes, as per the coding guidelines. InfiniteBPO’s AAPC certified coders are veterans in accessing the completeness of patient’s medical records and providing Hospital / Provider Coding Services.

Other specialised services in our healthcare service spectrum are Medical Billing and Revenue Management Services. Our experienced personnel thoroughly review the Insurance Policy Details / Explanation of Benefits / Patient’s Medical Records to ensure that the claim is error free.  The team ascertains the party liable for the pending payment, and does regular follow-up with the liable party (Insurance / Patient) for the payment recovery.

Our healthcare service offering includes the Healthcare Payer Services, where we provide Pre-adjudication, Adjudication & Post-adjudication services to the Payers. A key offering is the cost containment services provided by our Claims Audit team for Insurance Companies & TPAs in Healthcare space. InfiniteBPO has rich experience working on clients Data Mining Software and various claims processing softwares and understand its functionality in detail.

InfiniteBPO help clients in streamlining their processes and bring in operational efficiencies thus reducing costs. We use HIPAA complaint proprietary software application for workflow management which was built using robust technology tools.

InfiniteBPO Breadth of Healthcare Skills

Provider

• Health Claims Administration Services
• RCM / Practice Management
  • Eligibility Verification
  • Medical Coding
  • Patient Demographics (Charge Entry and Payment Posting)
  • Charge Entry (Charge Entry and Payment Posting)
  • Payment Posting (Charge Entry and Payment Posting)
  • Claim Generation (Charge Entry and Payment Posting)
  • AR Analysis (AR Analysis and Denial Management)
  • AR Follow-up (AR Analysis and Denial Management)
  • Denial Management (AR Analysis and Denial Management)
  • Financial Performance Analysis

Payer

• Health Claims Administration Services
• Pre-adjudication
• Claims Processing / Adjudication
  • Electronic conversion of Paper Claims
  • Adjudication
  • Re-pricing
  • Settlement
  • Benefit Plan Verification
• Cost Containment Services
  • Duplicate Payments
  • Payment over and above contractual rates
  • Other external payments
    

Healthcare Provider Survey Support Services

• Satisfaction survey with contracted healthcare providers
• Information Gathering Surveys
• Service Rating Surveys
• Verification Surveys

Audit and Review Services – Provider and Payer

• In-depth analysis of billing and reporting procedures
• Credit Balancing
• Prepares and submits the documentation required to support a retroactive medicare rate adjustment
• Coding compliance auditing services
• Professional compliance auditing services
  • Utilization review services
  • Provider-specific audits (benefit specific), comprehensive of a provider’s complete practice
  • Resource-based relative value scale provider fee schedule
  • Audits to assure correct process is followed for determining network discounts and allowances for out-of-state providers
  • Audits to determine that the correct network is utilized for out-of-state provides
  • Audits to determine timeliness of claims payment and other provider satisfaction issues
  • Review and respond (or provide recommendations) to appeals related to audits.

InfiniteBPO is a proven Market Leader in the US Healthcare services & strives to achieve excellence in the service offerings through continuous process improvements & innovations. We make constant efforts to add value to the customers by enhancing our capability & increasing our portfolio offerings, and have progressed from offering entry level services to High end services.  Our present endeavour is to leverage on our experience & broaden our service offerings by exploring opportunities in the Underwriting Services, Insurance Contracts Negotiation, Coding Audit, Healthcare analytics etc.