TBS works with both Providers and Payers to bring improved solutions and processes to the Healthcare Industry. Once we work with a client to identify needs, then together with our team and our Partners we provide the solutions to remedy the issues our Healthcare clients are struggling with.

Revenue Cycle Management-Claims Management-Analytics

Healthcare Provider Services

We understand that increasing your operational efficiency and maximizing your productivity is critical to your business operations. In the current market scenario, the costs to administer claims and retain staff continue to rise and erode your profits. We enable you to focus on your core business area and contribute to the revenue enhancement. Our services on the Healthcare Provider front can be classified as follows:

Hospitals | Physicians | Clinics Medical Coding Revenue Cycle Management AR Analysis & Denial Management

www.tbsmedicalbilling.com

 Underpayment Recovery Services

One of the most effective programs many hospitals are now using to address the whole issue of underpaid claims is called an Underpayment Recovery Audit. There are only a few companies that have the resources and technologies available to deliver highly effective results. A thorough underpayment recovery audit will include a review of all zero balance accounts from the past 24 months. These would include all claims that have been set to a zero balance whether they were paid in full, paid partially or totally denied. The review of these claims should uncover about 6%-7% of a claims reviewed as being underpaid. Once identified as an underpaid claim, a rebilling of that claim would take place to recover those funds. The most effective companies are recovering up to 75% of the underpaid claims identified. Get more detailed information on Underpayment Recovery Services Here! 

ICD-10 Auditing and Coding Services

Now that the ICD-10 regulations have been in place since this past October 1, denied claims may now becoming an issue for those organizations that were not properly prepared. TBS has been providing ICD-10 Auditing Services to Hospitals and Physician Groups since the regulation went into effect. The purpose of the Audit Services is to inspect completed charts of the coding staff to find any discrepancies related to ICD-10 Coding. Once found the issues are brought to the attention of the coders as well as management. This serves two purposes, one to improve the coding proficiency of the staff and second to enable the administration team to resubmit claims when and if a claim was denied.

In addition to our Auditing services TBS also provides medical coding services through our proprietary coding platform that recruits, tests and validates their coding certification prior to adding them to our groups of nationwide certified ICD-10 coders available to supplement any hospitals coding needs. All of our coders and Auditing staff are certified ICD=10 coders and or trainers that access our clients coding software remotely through our centralized secure coding portal through an encrypted connection. To receive more information on our coding and auditing services Contact Us Here!

Healthcare Payer Services

TBS provides a full range of Claims Administrative services. Our services give you the highest payment accuracy with lowest operational cost. We practice matured Process Flows, State-of-the-Art Quality Assurance procedures. Our Claim Analytics are done by trained professionals possessing deep domain knowledge. We possess a deep understanding of both the Payer and Provider domains which results in total control on overpayments.

We use HIPAA compliant proprietary software applications for workflow management that has been built using robust technology tools. A couple of the process steps are handled after verifying data from several databases of payers resulting in increased Administrative Efficiency, Reduced Costs, Quick Settlement of claim payments and a true ROI.

Insurance Companies | Health plans | PPOs | TPAs | IPAs | HMOs Claims Administration Enrollments Maintenance Provider Database Management Network Management Utilization Management

HIPAA compliant proprietary software

Healthcare Analytics Services

TBS has always endeavored to provide value-add to its clients by providing niche services. Leveraging on our deep domain expertise, in-depth experience of both the Payer & Provider domains, TBS is able to provide complex high-end services from both its onshore and offshore locations.

Provider Analytics Services

• Payment Integrity Validation-Underpayment Recovery Auditing
• Code Review Audit
• DRG Audit

Payer Analytic Services

• Payment Integrity Validation-Overpayment Recovery Auditing
• Claims Reconsideration
• DRG Compliance Audit
• Hospital Bill Audit