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Showing posts with label AI and Medical Billing. Show all posts
Showing posts with label AI and Medical Billing. Show all posts

Monday, June 8, 2020

AI and Medical Billing

Tranquilmoney: AI and Medical Billing
Hospitals generally are full of paperwork. Beginning with new patient registration, medical reports, prescriptions, insurance documentation, and sensitive patient records, healthcare professionals deal with a plethora of data. All these data is critical to everyday hospital workflows and it includes a lot of paperwork, which has to be done manually.
While this conventional form of maintaining data is being practiced all over the globe, the shoddy software work that is trying to replace it is worse!
It drags efficiency, agility and is a cause of unwanted burden to the healthcare professionals, be it doctors, nurses or any other related professionals.
A study has stated that doctors spend less than 27 % percent of their time treating patients; the majority of the time is being spent on documentation, entering patients’ information into electronic health records (EHR) and other administrative works.
Such scenarios have led healthcare service providers to see that there is a growing need to better engage physicians with patients and to offer value-based and cost-effective services. Healthcare executives are searching for ways of cutting healthcare costs while maintaining the quality of care being offered.
Achieving this level of patient-centric engagement is necessary, however, it does not mean one can escape from the other hospital-related work. Yet, as said before this administrative work is dragging the efficiency and time of healthcare professionals while increasing the labor cost as well.
How can we move towards a patient-centric service that too in real-time and cost-effectively? One way of doing it is by automating the administrative tasks and invest the physicians’ or healthcare professional’s time elsewhere. Many healthcare vendors have stepped foot into the vast healthcare sector intending to offer effective health care solutions. Leveraging the power of rapidly emerging technologies, these vendors have designed solutions that improve hospital operational efficiency.
Tranquilmoney, Inc, is a healthcare software and service provider that leverages the power of technology to bring agility in the healthcare sector. This healthcare vendor has automated the common administrative duties and eased the burden borne by clinical administrative staff and physicians alike. It has also reduced the burnout, allowing the focus to shift from paperwork to patients.
Tranquilmoney, Inc. was founded in 2001 in New York, NY, with the acquisition of the Indian company M.M. Imagine Technologies Pvt Ltd (MMIT), a company that is part of the KC Mammen Mappillai business family group.
Journey to the Prominence
The complexities of healthcare claim and AR management, over and above the pressures on providers in the form of increased paperwork, lower insurance reimbursements or denials, follow-ups add to a huge administrative overhead.
Tranquilmoney’s Healthcare AR services combined with its powerful technology ensure expedited payment, reduce claim rejections and minimize administrative overhead besides total cost of ownership (TCO).
The evolution of Tranquilmoney as the leader in healthcare service providers began with its service as a consultant. Karun Philip, the Founder of Tranquilmoney, Inc. headed an AI research division at Tata Consultancy Services, India’s largest software company, where he built an AI-based document imaging system for the Unit Trust of India, the world’s largest mutual fund. This was from 1991 to 1993.
Later, he started Tranquilmoney as his consulting firm. Initially focusing on financial document processing, Tranquilmoney’s clients and end-users included:
 Citigroup
 UPS
 Prudential Securities
 McKesson Corp
 Costco Pharmacy
From Prudential Securities to Costco Pharmacy, Tranquilmoney developed a focus on processing US third-party healthcare receivables. This involved both software and outsourced actual processing of the claims and remittances, and Tranquilmoney was one of the first companies to use imaging, workflow, and Artificial Intelligence to enable workflows to be spread across the globe rather than centralized in a single building.
The Proprietary Software
Today, Tranquilmoney is turning its pharmacy receivables to solve the problems of small physician practices. Knowing that the EHR requirements were also putting a burden on small practices, Tranquilmoney built its PracticeTracker™ application to offer Practice Management software, certified EHR capabilities, and Medical Billing services. The turnkey solution results in being a profit center from increased collections, free EHR implementation, and low-cost customization for each practice.
This propitiatory software comes as a software-as-a-service, plus a dedicated back office team that is located in the Indian office. The software also provides a detailed ‘Totals Management,” an online implementation of W. Edward Deming’s American Management techniques, which Japan misleadingly labelled Japanese Quality Management. But the concepts are the same.
“To get anything done, train the people.”
Automated training process with all people in a Physicians Practice’s Front Office and Back Office are measured by metrics based on ‘PQDCM’; Productivity, Quality, Delivery, Cost, and Morale.
However, the best part of using the Tranquilmoney’s technology is that it works with whatever software the physicians’ practice already has in place or provide its PracticeTracker™ software free of charge. “In many cases, clients start with what they have (in some cases just physical paper charts) and slowly move to PracticeTracker™, which the company customizes for each client according to their specialty and individual desires,” asserts Mr. Philip.
The physician practice market is very fragmented, and there are about a million practitioners, 80% of whom are in small practices. Physicians are losing at least as much money in underpaid claims as it costs to the bill in full detail with documentation, and follow up on every dollar billed. There is no market leader in software and business services for this market. Tranquilmoney’s approach has been to first be the best, and then start moving to be the first.
The Purview of Tranquilmoney
This company essentially works for the Practice Manager of the doctor to handle all the business aspects of running a healthcare practice. This includes software, applications for registration of various kinds, patient scheduling and follow-up, technical assignment of billing codes, electronic or paper submission of claims, receipt of checks and EOB’s (Explanation of Benefits) that say which claims are paid by the check and by how much.
The company’s mission is to serve US Health Providers. This includes doctors, therapists, medical clinics, hospitals, and pharmacies. It maintains good relationships with insurance companies, and their TPA’s (Third Party Administrators) and PBM’s (Pharmacy Benefits Managers) to ensure that only fully documented and accurate claims are submitted, but follow up on every dollar that it finds unpaid or underpaid.
Around 80% of doctors are still in small practices and cannot afford the increase in costs due to regulatory and technological mandates that are now required. This will inevitably trigger reductions in insurance reimbursement to physician practices. Many physicians are retiring early or taking jobs in hospitals due to this.
Tranquilmoney is here to provide them all the assistance in technology, operations, and legal compliance, with Zero cost, because of the increase in collections that result from its technology and services more than cover its fees. “We look forward to the modernization of this sector without independent physicians having to waste valuable time in bureaucratic processes, while we take care of the business and financial angle of their practices,” asserts Mr. Philip.
At Par with Emerging Technologies
Technology, like in every field, is the solution to the problems in the complex 3-party relationship between doctor, patient, and insurer. Once the whole system is tech-enabled, the data can be anonymized and used to analyze the huge amount of information available to find the most effective is at the lowest cost to the system.
However, transitioning from legacy systems or paper systems to the newer certified technology is very expensive, and training of current staff is also critical and often expensive. Tranquilmoney provides both the technology and business services at no cost to the provider, no inaccurate billing to the insurer, and full accounts reconciliation between all parties.
Promise Until the End
Tranquilmoney took 20 years to help the pharmacy industry move from paper to almost electronic systems. Its continued goal will be to offer services to improve the efficiency of physicians and everyone associated with healthcare service. “With Tranquilmoney’s experience and expertise, we can do the same to the much larger healthcare provider space within the decade. We operate by segmenting each of our tech system and business process outsourcing operations into the smallest possible pieces so that we can integrate with other solution providers of all types, or just manage the whole end-to-end process ourselves,” concludes Mr. Karun Philip.
Exclusive
Tranquilmoney, Inc. provides software and services to the US healthcare industry. Based in New York, it has 14 years of experience in Healthcare Information Technology and services. Apart from physician practice management, they also provide claims reconciliation services to retail pharmacies, managing over $700 million a year in third party receivables.
The ‘PracticeTrackerTM’ is a web-based Practice Management software of Tranquilmoney, Inc. It comprises front office tasks and allows the organization’s back office employees to bill, follow up and collect more.
PracticeTrackerTM Self Service:
Software on the cloud
Monthly subscription option
Software on the cloud + other services
1. telePractice: Global telehealth solution
2. Use PracticeTracker™ EHR online
3. Schedule appointments
4. Enter ICD9, CPT, SOAP notes
5. Print own paper claims
6. Export to clearing house-ready format for electronic submission
7. Post cash
8. Do secondary billing
9. Print patient statements
10. Set follow up reminders
11. Standard reports online
12. Full document Imaging
13. Free email support
Practice TrackerTM Full Service
Software on the cloud + other services
One time service or Annual contract option
Everything in Self-service + following:
1. Complete Revenue Cycle Management
2. Set up assistance
3. Data transition support
4. Scan us the paper, next day data capture
5. Support for Patient Call
6. Support for MU incentives
7. Custom Reports
8. Free phone and email support
9. All-inclusive monthly billing
PracticeTracker™ Add-on Services
Tranquilmoney has 10 years of experience in providing these professional and friendly services to many doctors and practices.
E-Prescription: Electronic prescription to pharmacies. Includes formulary check, alerts on drug-drug and drug-allergy interactions (Dr. First Rcopia database)
Credentialing Support: Provider is enrolled with requested insurance carriers
Support for MU Incentive: Paperwork for applying for MU incentive done and guidance given for meeting requirements for getting incentive
Data Conversion: Convert paper patient records or charts. Data is double keyed from scanned paper and billed per record/form (volume discounts available)
Scanning: Paper couriered to Tranquilmoney office in NYC is scanned and emailed or ftp-ed back to you
Data Transition: Existing data in a different software is analyzed and transferred to PracticeTrackerTM as part of transition
Custom Programming: Customizations in PracticeTrackerTM.
The organization undertakes end-to-end Medical Billing and AR Follow Up Services. The services are designed by an experienced team, who have perfected the method to improve the revenue cycle. Coding and other errors are reduced and as a result, so are delays and denials. Coupled with an equally well-designed collection/ AR follow up process, the services can improve collections tremendously.
Given below are the services offered:
• Medical Coding
• Patient Eligibility Verification
• Charge Entry
• Claims Submission
• Payment Posting
• Denial Management
• Reporting
• A/R Collections
• Credit Balances
• Patient Follow Up
• Insurance Follow Up

Review by MD Tech magazine

Interview with Dr. Karun Philip It will be great if you could give me a brief background about your company as to what you do and you know, ...