Electronic Health Records (EHR) Management and Challenges in Long Term Care Industry

The four most critical challenges faced by the Long Term Care industry today.

Shortage of Nursing Staff : One of the major challenges in the nursing homes today is shortage of adequate nursing staff. This has a direct impact on the service provided by the nursing staff as the residents have to wait for assistance from the nurses. In other words, the residents’ activities of daily living (ADLs) like bathing, dressing, eating, medication etc…are at times not being done in a timely manner. Hence it is very important for the nursing homes today to have adequate nursing staff.

Complex Regulations : Proper documentation and management of medical records is the most integral part and is a mandatory requirement for any Long Term Care facility. Nursing staff has been efficient in adhering to these requirements. But this is not the case in all Long Term Care Facilities. Errors may occur in cases where documentation is done manually. This increases the risk of regulatory citations and this can be avoided with a proper Electronic Health Records system in place. It would be any added advantage if your EHR software has both financial and clinical systems integrated under one system to take care of both financial and clinical functions in one platform.

Rising Operational Costs : Rise in operational cost directly impacts the cost of treatment given to the resident. Long Term Care facilities must have effective systems in place to controls costs. One option is to outsource their financial and clinical documentation part as this is a time consuming activity. This not only reduces the cost as there is no need to have additional staff assigned to perform these activities but also allows the LTC staff to focus on their core activity of providing quality health care to the residents.

EHR Management : It is very important to have a right EHR system in place. A lot of Long Term Care Facilities end up acquiring a system which is generic and not a customized platform. In this case LTC facilities are paying for software which has some of the functions which they might never use or which does not have some of the functions and are doing it manually. Hence it is very important to identify a right vendor who can provide you a customized and cost effective solution for your EHR software.

Any comments are welcome.

For further questions on effective EHR management call 408-856-6651 or e-mail chiragb@promantra.net

Accelerating your Revenue Cycle process

Promantra Synergy Solutions is a HIPAA compliant organization and has over six years of experience providing Healthcare BPO services to Hospitals and Physician Groups. Our comprehensive billing solutions provide better compliance at lower costs, enabling our clients to focus on their core business that is, providing better health care.

We have all the capabilities that can improve and accelerate your revenue cycle process, so you can achieve higher productivity, faster payments, decreased costs, and improved patient service by effectively providing the following across multiple specialists:

> Patient demographic entry
> Insurance Eligibility verification
> Medical transcription
> Procedure Coding
> Diagnosis Coding
> 100% Charge capture
> Reducing your current aging AR bucket
> Collections
> Identifying root cause of claim denials
> Follow-up on denied claims
> Follow-up on pending claims
> Resubmission of claims
> Real time reporting / customized reporting

With a robust team working on transitioning and stabilizing processes with the client expected quality and turn around time, Promantra can assure you savings up to 30% to 40% on your current operational expenses. We look forward to present our credentials and walk you through our service offerings in detail.

Chirag Patel
E-mail : bd@promantra.net / chiragbp@promantra.net
Phone : 408-856-6651

Why Outsourcing to India Spells Good Business

Outsourcing is one of the strategies to respond to unprecedented market situations. The prevailing climate makes outsourcing even more vital for any business. It not only helps you survive the adverse economic climate but also thrive in unfavorable times, like economic meltdown. Outsourcing can actually add many dimensions to your business. In addition to cost cutting and immediate savings, outsourcing can also add other verticals to your business, like, controlling your cash flow, liquidity issues thereby encouraging your growth prospects. The goal is to help your organization come out strong and competitive, especially in times of financial turbulence.

The prospect of outsourcing service provider companies is large. Companies now are in search of providers that can help them with their knowledge, capability and expertise. Companies now look for providers with a good track record of success. This helps them in developing their faith that the providers can help them in bringing dramatic changes in their business. Promantra has that expertise, experience, flexibility, scale and reach that can help an organization in bringing down their cost of expenditure and increasing their margins of profits.

At Promantra, we have:
More than five years of experience in outsourcing
· Successful and satisfied clients
· More than 450 experts with strong domain knowledge
· A 24/7 round the clock delivery model

Establishing an Outsourcing Contact with Promantra can help you in:

· Improving your bottom-line performance
· Increasing efficiency
· Reduction in operational costs
· Better utilization of technology

Outsourcing is the most important tool in minimizing your cost and maximizing your profit without compromising for the quality of work. With a vast population of English speaking graduates, today India is the destination for outsourcing almost all business processes.

Peaks and Valleys of Healthcare Industry

Healthcare outsourcing units are often described as adding a second arm to the Indian outsourcing business. After medical transcription, disease management and claim processing are the fastest growing areas of Healthcare BPO. The drop in the revenue of the medical transcription industry from $38 million in 2002 to $26 million in 2006 resulting in a loss of almost nine per cent per annum led many to believe as the first sign of the collapse of the health care BPO in India. A report by NASSCOM revealed that the Indian health care outsourcing industry can capture $800 million alone from U.S health care service by the end of 2005.

Industry analysts are of the opinion that competition in business arena, technological and legislative changes worldwide are the key factors in driving more business to this sector. NASSCOM in one of its report says, "The recent customer demand for new products and services, increase in competition and a real-time business environment are making BPO an important toll for achieving success for health care majors". The health care industry is in consistent pressure. The need for cost efficiency provides the Indian ITES industries with a huge potential. What the companies need is to tap this market in more sophisticated areas, like disease management, claim processing or imaging.

While the Indian companies have somewhat captured the U.S or U.K market, a huge market remains completely untapped in countries like Germany and France. Language constrain here plays an important part. Till date, U.S is the largest market provider for health care outsourcing. But to sustain the competition, the Indian BPO players need to explore its possibilities in these areas as well. Quality human resource pool with a sound knowledge and experience in complex applications remain to be the latent strength for the Indian Health care BPO. In addition to this they also provide value added services, like diagnostic review by medical professionals.

All these services are provided in the most possible cost efficient way and charges only a fraction of their U.S or U.K counterparts. Another prospective area of growth for the health care BPO is in Clinical Research Organizations. These organizations conduct pathological experiments of new drugs on patients. The criterion here is that the company must be accredited by the College Of American Pathology, the global standard for pathological governance for projects related to these experiments.

But while extending its limits, the health care BPO operates with the conventional limitations of Business Process Outsourcing units. Like any other process, data protection and information security pose to be the two major threats for this industry. The industry confronts a constant challenge in sensitizing information and client data. While the peaks of health care BPO look shining with more services and prospective clients from new geographical locations, the valleys of data security and confidentiality can not be overlooked.

Considering the huge possibility of this industry, the response for health care BPO was almost instant. They plunged into this industry in the form of medical transcription. But now it's time for them to move ahead of medical transcription, enhance their domain knowledge and add new verticals to their Healthcare BPO services.

Economic downturn will drive in more business to Indian BPO

The failing world economy is a matter of concern to the global business. Leaders of small and large business are struggling hard to weather the storm of economic uncertainty. The headlines of a recent article in The Wall Street Journal shows "Executive shift to survival mode" as the strategy for this economic downturn. The economic pressure has raised the demand for Business Process Outsourcing. The Research and advisory firm, Gartner, in one of its reports shows that by 2010, the Indian BPO companies are expected to double its market share. Indian BPO players, like, WNS, Genpact, Aditya Birla, Minacs have proved themselves as powerful opponent to Western BPO.

By the end of 2008, the leading 20 Indian BPO reported a revenue of $4 billion, which is 5 per cent of the $80 billion revenue of the major 150 BPO companies. Another report by IDC provides an in-depth analysis of the current trends and opportunities in BPO, with special emphasis on Finance and Accounting BPO. According to this report, the customer trend shows a clear preference for supplier consolidation that are found in multi-function full scale BPO, like Accenture, or IBM or the Indian counterparts, like Infosys, HCL or Wipro.

If properly used, BPO can be a great tool in helping company survive the economic downturn and then thriving when the climate calms. Let us take a look at the benefits of BPO and why it is sure to bring in more business during the economic downturn:

• Decrease in the pricing structure: With right scope and service level, a business can attain a significant reduction in its cost structure within two to three quarters by outsourcing to third-party outsourcing providers. The savings can be 30 to 60 per cent of the current cost base.
• Changes fixed cost to variable: During periods of economic uncertainty, the volumes of business changes and the key to better management is to align the volume of your business to its cost. An important feature in many of the BPO is Unit Transfer Pricing or UTP. In this kind of approach, transactions are priced on per unit basis.
• Retain Customer Focus: It is the customers that suffer the most when it comes to any kind of change; merger, down-sizing or change in market focus. Reduced employee headcount should not mean a drop in customer care service. Losing customers can create a problem of survival and existence for an outsourcing company. BPOs actually aims in improving customer care service, not only by maintaining customer loyalty, but also shaping customer revenue. By facilitating customer interaction, BPOs can add as much as 50 per cent increase in your total revenue.
• Transparent Cost Structure: Information is a valuable asset. This is all the more true for economic downturn. Knowledge of the actual cost of delivering business processes is important. The very nature of the work, eliminates guesswork providing clarity to the components of cost.
• Put more focus on knowledge: In challenging economic times, the knowledge of identifying the right fact is necessary. Who is the customer, what will he buy, when will he buy, how much will be the cost of production-these are all essential knowledge that distinguishes a survivor.

2009 Cardiology Billing

This year marks to be one of the important years in medical billing and coding reformation system. Since 1990, this has been the most important change in the cardiology billing and coding system. The alternation in this year's billing system is sure to hit the cardiologists hard. Instead of 1% increase of the average physicians, the cardiologists this year finds a 2% per cent reduction in Medicare fees. But this 2% reduction in Medicare for cardiology can not be applied uniformly. There is a group of cardiology practitioners, like the heavy users of echo services, that remains above this reduction in cardiology billing.

Following are some of the recommended modifications for cardiological billing and coding:

• The codes used for follow-up on implanted devices and external devices have been completely replaced. The revised version now include codes for reprogramming of ICD and ICM devices, Loop recorders, Pacemaker and interrogation.
• The new codes are service specific. The most important is that every service now has its own specific corresponding code. Be it interrogation evaluation of a programming or reprogramming of ICD or ICM device, there is an assigned code for everything.
• Devices, such as, Cardionet also have codes now. The concept of billing unlisted code has become completely obsolete because of the recent change in billing and coding system.
• The global period of device follow-up is now changed to global periods of 30 or 90 days.
• The echo services also got its new code, for example, when echo is done with the help of a Doppler, now it gets a new code to submit that bunch of service into a single code.
• The same holds true for new stress echo code. The stress echo code combines the stress test code and stress echo code in a single code.

These are some of the major modifications of the cardiological billing system of 2009. The medical billing companies should be aware and well versed about these changes. A slight mistake or misconception might result in a huge loss. So 2009 is the time for the medical billing companies to upgrade and update itself to the latest changes in the cardiological billing and coding system.

Save 40% to 50% by outsourcing your Medical Coding project

The reason for the outsourcing boom is largely economic. Outsourcing helps you in saving a substantial amount of money without compromising for the quality of work. This remains most instrumental in the boon of the outsourcing business. Be it Business Process Outsourcing or Knowledge Process Outsourcing, the concept remains the same: high quality work at reduced rate within a specified turn-around-time. This is no exception for medical coding.

According to the statistics published by American Academy of Professional Coders (AAPC), a certified U.S medical coder charges as high as $39,000 per year within his first two years of work. In an annual survey by American Academy of Professional Coders (AAPC) in 2005, brings to light the fact that a medical coder with about 10 years of experience charges around $45,000 annually. Education plays an important role in deciding the charges of the coders. A U.S medical coder with a master's degree charges $58,000 annually on an average.

Medical coding is an integral part of medical reimbursement process and can not be overlooked for a successful medical reimbursement. Outsourcing comes as the only viable option and relief from these ever mounting costs of medical coding. At the same time, outsourcing of medical coding projects ensured same high quality work within specified turn-around-time. Another survey on outsourcing of medical coding projects shows that outsourcing medical coding projects can save you at least 40% to 60% of your total medical cost. This reduction can no doubt increase your share of profit, but the quality of work can not also be overlooked.

The medical coders of Promantra are certified by American Academy of Professional Coders (AAPC) and holds years of experience in medical coding. Further, our medical coders comply with the ICD-9-CM Official Guidelines for Coding and Reporting, AMA Guidelines from CPT-4 Code Manual and CMS (HCFA) Guidelines. Our coders also comply with the regulations of HIPAA in order to meet the set standards of Patient Health Information (PHI).

With an infrastructure certified to the international standards of ISO 9001:2000 and ISO 27001:2005, we assure complete data protection for the client. With years of experience in delivering high quality work within turn-around-time, Promantra medical coding service assures you the full advantage of outsourcing. Find a considerable reduction in your costs along with minimal denials by outsourcing your medical coding projects.

Electronic Medical Transcription

Like everything, medical transcription has also been through phases of evolution. Medical transcription is a rather dynamic industry with new experiments and additions going on everyday. The industry evolved from manual typewriters to electronic typewriters to word processor and then to plastic disks, magnetic belts and finally to digital recordings. Voice Recognition System or VRS is the recent evolution in the medical transcription industry.

VRS is used by medical transcriptionists and proof-readers in providing supplementary editorial services. There are certain cases where the VRS has completely replaced medical transcription. Earlier, medical transcription (MT) consisted of handwritten notes with lots of abbreviations and responsibilities of the physician. These notes and interpretations were then supplemented in patient’s file for reference.

The handwritten notes and typed notes are all consolidated and kept in a file along with the records of other patients for further reference. Whenever, a physician required the record of a specific patient, the patient’s file is retrieved from the huge mass of files. To enhance this process, usually two or three carbon copies of same medical record are kept in a single file.

But now things have completely changed. Huge files have given way to desktop computers that are connected with powerful servers. A patient’s record is processed and archived individually in these servers. The unique digital format allows instant access to these servers even from the remote location. Medical transcriptionists now work closely with the programmers to stream in voice and get continuous data through network interfaces.

In fact, healthcare providers now make use of personal data assistants (PDA) and other softwares for their service. The Computer Aided Medical Transcription (CAMT) is a software that is exclusively designed for medical transcription industry. The CAMT has several benefits that are attributing to its popularity. Following are some of them:

Changing Medical Dictation to Text: The CAMT software change spoken words to texts. This software was especially developed for medical transcription.

An Efficient Interface for Medical Transcriptionists: Using these softwares you can easily increase your editing speed. In these softwares, editing is done as fast as keyboard stokes and shortcuts.

Interpreting and Formatting Document: CAMT perfectly understands what a physician intends to mean and transcribe accordingly. For example, the software understands when the word "next" refers to ‘3’ in the list and when the physician uses it to mean the next section.

Every year the healthcare providers spend thousands of dollars for the increased charges of the MT industry. Further, there also had been a dearth in the number of efficient medical transcriptionists. The advent of the CAMT helped the service providers in saving few dollars that they would otherwise spent for the MT industry.

The invention of CAMT has revolutionized medical transcription industry. It can now deliver high quality work within turn around time (TAT). The software is simple and easy to use. This software has brought this industry at the edge of a huge change and it’s also time for us to change our concept of medical transcription.

AT Promantra, Electronic Medical Transcription attains a different height. We use a special software for medical transcription, named Proscribe. Proscribe handles the tiring job of file allocation and also checks the accuracy of the transcription. Proscribe would be soon taken to a new level which would include VRS that could be used for automatic dictation. Electronic Medical Transcription at Promantra is geared up with all modern paraphernalia to serve its existing and prospective clients with flawless transcription.

How BPO cope with the present economic meltdown

NASSCOM released a report that shows that the Indian BPO sector is no longer in danger of losing jobs. The New Year is about to bring good news for the Indian BPO. NASSCOM denies the prediction that the Indian BPO is about to undergo huge job cut of about 2.5 lakh in the first quarter of 2009. On the other hand, NASSCOM declared that only after an extensive research and interaction with its member companies, it has come to this decision. In fact, NASSCOM is about to release its forecast for the fiscal year 2009. It further added that BPO industry will continue to hire and the fear of large scale job loss is not expected. Along with these positive inputs, NASSCOM also expressed its fear of loss of huge manpower if the Government did not grant the fiscal package.

The US economic slump has done what the BPO sector has been trying to do for years- lower the attrition rate. From 30-40 per cent attrition rate in the beginning of this year, the number has come down to 15 to 20 per cent. The industry experts are of the opinion that the companies are most likely not to miss this chance in rationalizing the salaries of the BPO employees.

Genpact, one of the largest BPOs of the country, reported an attrition rate of about 26 per cent for the first nine months of the year 2008 as against the 30 per cent in the same quarter in 2007. Whether it is Satyam or Cbay the economic downturn has slowed down attrition rate at least by 15 per cent. Infosys BPO has also seen a lower attrition rate for the last few months. However, the company has no plans for job cuts with the slump in US.

What is certain is that the salary of this sector will be rationalized, not only for entry level but also for the middle and senior level. The drop in salary is expected to be over 5 per cent. Further, it is implied that the increase in salary will depend on productivity. There will be a fixed salary; the change will only be in variable pay.

The Business Process Outsourcing sector has thus taken many measures to survive this economic low tide. The sector is struggling to cope with the financial downturn, but any further addition to this might prove fatal for this industry.

Revenue Cycle Management

Revenue Cycle Management (RCM) forms an integral part of hospital management system. Insufficient or poor revenue cycle management might cost your hospital to loose two to three percent of its net annual revenue. The term “Revenue Cycle Management” carries multiple connotations. Some use it to describe claims those are denied of medical necessity, while others use it to show how the information, procedures and service plan are tracked for a specific payer.

Yet, there is another group that associates it with the daily work of a physician’s chamber. So, do not be disappointed at the blank look from your medical billing company for questions like: what is your strategy for revenue cycle management or what are its results.

An effective revenue cycle management system manages the data for the billing process. This accelerates and increases the flow of cash. A good reporting needs to be comprehensive managing all claims. If used properly, revenue cycle management can reduce claim denials by at least 50 per cent.

Promantra Revenue Cycle Management service helps healthcare organizations attain the above goals resulting not only in high revenue management but also increased level of satisfaction. We specialize in the revenue cycle management of long term care organizations. We collect and monitor the rightful reimbursements for the service provided.

To accelerate the velocity of our revenue management cycle, we have compartmentalized the entire process into different sections, like: Admissions, Insurance Authentication, Charge Processing, Billing, Follow Up for Collections, Payment Posting and Bad Debt management.

Our RCM service is delivered exclusively through our proprietary GeroPro platform. This unique platform helps us in managing the contracts (Medicare & Medicaid) of Long Term Care Organizations, authenticate their reimbursements and also provide systematic resident estimate. We also bill for Medicare, Medicaid, Insurance, Co-Insurance for third party and private payers.

Our Revenue Cycle Management service assures you minimum denials. The healthcare system has been striving through a challenge of minimizing cost; the traditional efforts have proved insufficient in reducing the financial margins. Revenue Cycle Management is an effective solution in such cases.

With an experience of more than five years, Promantra has been delivering quality RCM service for Long Term Care units. Certified to the standards of ISO 9001:2000 and ISO 27001:2005, Promantra Revenue Cycle Management assures you rightful reimbursement.

Increase value and reduce risk with outsourcing strategies

Outsourcing is a strategy that the firms and corporations are increasingly using to reduce costs and increase their share of profit. Although companies found outsourcing as one of the significant ways of minimizing costs, but the risks involved in it should also be considered. It is expensive to maintain a large application development and testing staff. So more and more companies favor outsourcing to specialist third parties, who have experienced and skilled resources.

It has often been seen that industries, which have no history of outsourcing often finds it difficult to complete its outsource project successfully as against companies that have knowledge in outsourcing. Most of the projects undertaken by retail and public sectors are successful (77.5% and 65% respectively) where as the transport and financial sector show massive failures because of their inexperience and lack of knowledge about outsourcing.

Careful planning and control are the key determinants in seamless completion of a project. The primary reason for outsourcing is to develop software applications at a reduced cost and also the need to boost resources through access to skilled resources. It is generally expected that outsourcing will increase in the next few years. Although the rate of increase will be lower than as compared to the prior aggressive growth, but at least 20 per cent growth is expected.

If you aim to increase the share of your profit through outsourcing, the first thing that you need to determine is a reliable business partner. An organization should entrust the responsibility of outsourcing to a chosen partner. Thus the organization needs to follow secure coding best practices, the application that has been developed with adequate levels of security. The importance of security increases even more as the organizations are outsourcing such sensitive data as financial and human resource application.

Public sector and retail are the two industries that outsource their sensitive documents and even then they have fewer issues with their projects. The very fact that legal action has been taken in some cases describes that there is a problem in the contract that provides nothing for the companies to fall back on. Hence outsourcing may not be considered as risk, so long as the correct strategies are taken. Experience plays an important role here.

Thus if a company does not have experience in outsourcing, it is likely that it can attract penalties thereby reducing its profitability and adding to the cost of the outsourcer. Before a company starts any of its outsourcing projects, it is important that it gets the contract right. No matter how much time is required, the company should set what are the goals for the development for a particular application or service. The requirement of software or a particular service should form the basis of any contract and it should be reinforced through any service level agreement.

It is also important that the outsourcing company should identify the requirements for application security and also the tools and techniques required to develop the software application in a safe environment. But this is not enough. The company has to have some kind of certification to assure the outsourcers about the security.

It is the responsibility of the organizations to define the tools and techniques that the outsourcer company should use. New vulnerabilities and vectors can occur at any point while providing service. But all vulnerabilities are not of the same order. So it is again the responsibility of the organization to prioritize vulnerabilities depending on the risk level.

The outsourcer should be able to assure the providing company that it can gauge any vulnerability that may arise during the process. In order to ensure the clients that the application has been tested at different stages of the software development cycle, the outsourcer must specify the exact security testing techniques that they use.

As security is the key criterion for outsourcing, it is better that the initial security testing is done by the clients. This, of course, does not mean that the organizations will not test the security by themselves. But it is considered best practice for the outsourcer to write that the client has the right to audit the security before application.

At Promantra Synergy Solutions, we adhere to a stringent rule when it comes to data protection and information security. Certified by the International Business Standard of ISO 27001:2005, data protection and information security are considered most crucial to all our HIPAA complaint healthcare services.

This is further enforced by our unique Healthcare Information Suite: GeroPro. The GeroPro platform gives us a unique flexibility of working with sensitive data in a completely secure platform. Before use, our software undergoes a thorough process of testing using the standards of SDLC. With a complete assurance for data protection and security, Promantra assures high-end quality work in a secured environment at a cost that is most reasonable.

India’s biggest competitor in outsourcing industry – A comparative analysis

The economic boon in India is primarily the result of outsourcing. India is heavily dependent and indebted to outsourcing for its prosperity. Like every other industry, the outsourcing industry of India also is not devoid of any kind of threat. The strengthening of the South-east Asian nations, like Philippines pose as a great threat for the outsourcing industry of the country. China is gradually emerging as a huge threat for the outsourcing industry of India.

A recent study by McKinsey concluded that the IT outsourcing industry of China is now often been mentioned in the same breadth as that of India, although India has no threat from China in the recent future as China needs to consolidate its fragmented industry to gain size as well as expertise. But the statistics generated by Gartner Dataquest, a U.S based research firm, completely contradicted this report. It shows that the IT service revenue of China was slated for a compound annual growth rate of 19.6 per cent and to reach $8.9 billion by the end of the year 2006.

Another study by IDC, a U.S based researcher shows that the IT service market of China is growing at a rate of 42 per cent since 1997. According to the January 2005 report of Yu Guangzhou, the Vice president of the Ministry of Commerce of China, the average annual growth of the Chinese IT industry was 30 per cent for the last five years. It also showed a growth of software export. In addition to that, it also showed that the sales revenue of the Chinese software industry had increased from $7.16 billion in 2000 to $19.3 billion in 2003. The software export of Chinese software has also increased from $0.25 billion to $2 billion in that same period of time.

The report by McKinsey also showed that almost 90 per cent of the IT services of China are locally done. In comparison, only about 28 to 30 per cent of the IT services of India are done locally. The growth of the domestic market of China should be considered as its strength rather than its weakness. China’s membership in the World Trade Organization and the 2008 Beijing Olympics are indicators of long term association of China in outsource industry. Without a strong local market, China can prove to be a tough competitor for the Indian outsourcing industry.

Among the South-East Asian nations, Philippines threats the outsource industry of India the most. According to the Philippine Software Industry Association (PSIA), the industry earned revenue of $423 million from both product software and outsourcing in 2007 as against only $200 million in 2005. The outsource industry in Philippines currently employs 28,000 software developers. For the year 2009, the most important areas of business for them will be customer support, like project maintenance, modifications that a customer might request for and like.

Beng Coronel, the current President of PSIA, described that Philippines is in a better position when compared to India and China in regards to the infrastructure and cultural affinity with U.S. But the uncertainty brought in by the President-elect Obama is casting a cloud on the sector. PSIA estimates that almost 45 per cent of the offshore software work comes from U.S and Japan and Europe contribute almost 25 per cent respectively for the outsource works.

In order to maintain its share in the outsourcing business, India needs to maintain a strong domestic market. China is training its people in English. Indian outsourcing industry should gear up or else there are every chances of loosing business. Another thing that should be considered is the cost effectiveness. Philippines is giving same quantity in a much competitive price. So, we should either make up by high quality work or by competitive rates.

Medical Transcription: The Future Perspective

Medical transcription industry brought great hopes and aspirations in the economic atmosphere of India during 1995-97. It can be described as India’s first step in outsourcing business. Even before BPO turned into a domestic name, medical transcription creates its impact on Indian minds. People were excited about the huge opportunity that suddenly stroke India.

The advent of the new millennium witnessed massive growth of BPO with its enormous opportunities and dollar dreams. As a result the medical transcription industry underwent a phase of dilemma. Just when a notion is developing that the medical transcription industry is down and out, it is staging its way back and is all set for an exponential growth in India. Cbay Systems, which is incorporated in early 1998 in U.S., has started acting upon its gigantic plans of expansion with about 95 per cent outsourcing from India.

Medical transcription is projected as the fastest growing segment among allied healthcare services. The demand for efficient medical transcriptionist is further instigated by the growing aging population and also by the HIPAA regulation, which declared mandatory to convert medical records into digital format. The Department of Labor in U.S., shows a growth of about 18 to 25 per cent of this business.

The voice recognition technology still can not read every human spoken word. Hence, the transcription can not be error free. It would take years to teach the software to get detailed and accurate transcription. Thus digital medical transcription becomes obvious. Outsourcing digital medical transcription further ensures that the work is done with equal accuracy and efficiency but in a cost-effective manner.

The good pay and relatively acceptable working hours have brought medical transcription outsourcing industry on the verge of a new beginning. As medical transcription requires only the voice recording, there is lesser chance for graveyard shift, which is most likely for the call centers. Unfazed by the global economic meltdown, medical transcription outsourcing industry in India is all ready for its growth.

V.Raman Kumar, the Chairman and founder of Cbay Systems declared that the company is looking forward for a phenomenal growth in the medical transcription outsourcing domain. The company is about to increase its strength from 700 in India to 5,000 and is looking for places, like Guntur for its operation. He also mentioned that the company has not lost any of its clients because of the economic turmoil.

The approximate strength of medical transcription industry in India is 18,000 and is expected to grow to 52,000 by 2010. U.S. contributes to about $ 25 billion in the medical transcription industry, of which $3 billion is outsourced. India’s share is only about $40 million of this total outsourced amount. Raman points out that U.S. is in dearth of medical transcriptionists. The situation is further complicated as the MTs expect double-digit rates. Hence outsourcing becomes inevitable and India expected to fill the void.

Medical Coding

Medical coding or Insurance Coding, as it is commonly referred to, is the process of assigning standardized codes to medical procedures and diagnosis so that it can ensure proper financial reimbursement for healthcare providers’ expenses. The entire concept of medical coding is to ensure timely reimbursement from the government and insurance agencies.

The physicians as well as the healthcare providers obviously want to be paid for their service and medical coding ensures this reimbursement. The reimbursement procedures primarily include descriptions of the services and the procedures that the physicians and the healthcare providers offer to their patients.

Why is medical coding important? Well before you bill, you should identify the medical services that you have availed. With different medications, procedures and specialties it is almost impossible for a patient or his family to identify the exact charge rates.

Even the healthcare providers and physicians are at times not sure about the charge codes, thus giving rise to demand for professional medical coders. Hence, to ask for these reimbursements the physicians as well as the providers need help of the medical coders, who can help them in billing their services and medications. This has given rise to government agencies, software companies and consulting firms that have experienced professionals for medical coding. Any discrepancies in billing for the services might result in denial of the claim.

Like every other industry, outsourcing is good news for the medical coding industry, as the same work can now be done in less cost with equal efficiency. Promantra is a forerunner in the industry of Medical Coding and Outsourcing. Today, Promantra is the proud possessor of a band of efficient medical coders that are serving overseas client efficiently for years. Our medical coders are all certified by AAPC (American Association of Professional Coders) and are skilled in providing high quality work within TAT provided by the client.

At Promantra, we strictly adhere to the regulations of ICD-9-CM Official Guidelines for Coding and Reporting, AMA Guidelines from CPT-4 Code Manuals and CMS (HCFA) Guidelines [CCI (Correct Coding Initiatives)] and [LMRP (Local Medical Review Policies)]. We follow HIPAA regulation in order to protect the confidentiality of Patient Health Information (PHI). Our coders strictly adhere to standards of ethical Coding. All the employees at Promantra sign a Non-disclosure Agreement and HIPPAA.

At Promantra we maintain the confidentiality, availability and integrity of information through the adopted security standards of ISO 27001:2005 and we aim to exceed the expectations of our clients and add value to their business by constantly monitoring, analyzing and improving our delivery processes through the adopted standards of ISO 9001:2000.

Promantra turns the key of success in medical coding not only by delivering quality work but also delivering it on time. With a minimal number of denials, today Promantra can claim to be one of the forebears of medical coding.

Medical Billing

Medical Billing is a liaison between the insurance company and the healthcare service provider. It refers to the process of submission and following up of claims to an insurance company for the services rendered by a healthcare provider. Medical Billing has always been an integral part of medical insurance.

With time, Medical Billing has developed into an industry with an annual revenue of about $2 million. It is a full fledged industry that includes, billing professionals, software developers developing the software for Medical Billing, healthcare service providers and of course the insurance companies.

In the last few years, medical billing was processed through paper work. However, with the advent of the Medical Practice Management Software, otherwise known as Health Information System, has enabled to manage large amount of claims efficiently. Software companies are coming up to provide medical billing software as they find this market to be particularly lucrative.

Owing to the rapid change of the US health insurance, many new aspects of medical billing have been created. Some of these new additions require specialized training. Hence several schools and institutions are coming up with specialized training programs for trained professionals in medical billing.

In order to provide service efficiently and promptly, the Health Insurance Portability and Accountability Act (HIPAA) came into being. It describes certain rules and regulations that doctors, hospitals, healthcare providers and health plans must follow while rendering medical service. From 2005, it has urged to send claims through e-mails so that there is no difficulty in receiving payments.

The introduction of HIPAA has been a huge challenge not only for the healthcare service providers and medical billing companies, but also for the patients as they have got into more waivers and paperwork. A typical billing process starts only after the physician or his staff creates or updates a patient’s medical record.

A medical record contains demographic information about the patient and summary of the treatment. It contains information on the disease of the patient, diagnosis, medication and also the mode of treatment. Once the level of service is determined, it is immediately transformed to five digit procedure code. The verbal code is changed to numerical code. These two codes are the determining factors in medical billing.

At Promantra, we provide expertise service in getting reimbursement for your medical bills. We assure you impeccable services from Generation of Claims till the Payment. Our experienced staff is well-versed in Carrier Follow Up and can surely bring back that smile of relief. We have a band of trained professionals that hold years of experience in Medical Billing.

Data security and quality management are given topmost priority at Promantra. Our ISO 27001:2005 and ISO 9001:2000 bear testimony to it. As recognition of our service, NASCOMM has awarded us as one of the Top 100 IT Innovators. With an extensive knowledge and experience in providing end-to-end services for the healthcare BPO, we know the most effective way to get payments for your Medical Bills. So if you are worried about your Medical Bills- Promantra is the right place to approach.