Services

Healthcare providers face various problems,
which can impede their financial performance –rising care costs,
alternative payment models, growth through consolidation,
consumerism, and the desire for a better patient experience.
HOM helps navigate through these challenges,
by providing end-to-end operations management solutions fueled
by intelligent automation and proven practices spanning
all settings of care.
With HOM, healthcare organizations will have an ideal revenue cycle
– one that fosters higher patient satisfaction, reduces costs, and
improves revenue.

Pre Visit

Collection of patient information and consent required for the medical record in order to meet established clinical, financial and regulatory demands.

Validating patient’s eligibility and benefits to ensure provider receives payment for services rendered. This help healthcare providers confirm coverage prior to the office visit, preventing subsequent denials & delays in payment. It helps in saving time at back end and improving patient satisfaction.

Procedure of obtaining prior approval from the payer(insurance company) before the healthcare provider offers services to the patient; Also called prior approval or pre-certification, it is a confirmation by your health insurer that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

Claim Prep

Identification of medical diagnoses and procedures and documenting them in a patient’s medical record as universally accepted codes, such as Current Procedural Terminology (CPT) code and International Classification of Diseases (ICD) code.

Recording information about the services provided into a medical claim for billing. Without ACCURATE documentation of clinical care services, revenue could be lost because charges are incorrect or aren’t made at all.

Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

Recording information about the services provided into a medical claim for billing. Without ACCURATE documentation of clinical care services, revenue could be lost because charges are incorrect or aren’t made at all.

Determines the amount of reimbursement that the healthcare provider will receive after the insurance company clears the dues.

Essential Value Adds

Ensuring\that the events of the patient encounter are captured accurately, and the electronic health records properly reflects the services that were provided.

Recording information about the services provided into a medical claim for billing. Without ACCURATE documentation of clinical care services, revenue could be lost because charges are incorrect or aren’t made at all.

Referral is the process of sending a patient to another practitioner (ex. specialist) for consultation or a health care service that the referring source believes is necessary but is not prepared or qualified to provide.

HEDIS® (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) to objectively measure, report, and compare quality across health plans. NCQA develops HEDIS® measures through a committee represented by purchasers, consumers, health plans, health care providers, and policy makers.

Receive Payment

Reconciling the payments received from the insurance payer to each individual claim. Once payments are posted, any secondary claims can be created and submitted. Once all insurance payments have been received and account adjustments completed remaining patient responsibility can be billed.

Tracking and managing unpaid claims ensuring that no time is lost on pursuing every reimbursement possibility.

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With decades of collective experience and deep knowledge of Healthcare Operations, our solutions are high-quality and cost-effective.