Rusan Medisys Pvt Ltd

Rusan delivers to health care providers an end-to-end solution which can yield a definite increase in operating margin, not just improved account receivables. Our end-to-ended back-office and knowledge processing solutions have increased the productivity and profit margins of our clients. This in turn has helped our clients to bridge the capital investment gap for upgrading existing medical services and it has also given them margins to address new challenges in the medical sector.

Some of our value-added solutions for the healthcare sector include:

Revenue Cycle Management

Rusan's cost-effective, end-to-end Revenue Cycle Management (RCM) offers billing support services to hospitals, physicians and successful third-party medical billing companies. Our RCM solution suite is uniquely customized to improve your profits and relieve you of the pressures of hiring, training and motivating ineffective employees.

Our RCM Solution Suite consists of:

Patient Registration		Charge Entry and Cash Posting
Claims Submission		A/R Denial Management
Medical Coding		A/R Collections and Follow-up

Medical chart audits and abstractions

Accuracy of information on medical charts and compliance of documentation as per prevalent industry standards is a vital aspect of the corporate healthcare industry. At Rusan Medisys, we make it our priority to ensure medical charts are precise and conform to regulations. Our audit and abstraction solutions benefit hospitals, health systems, providers and third-party billing companies.

Our qualified expert team reviews physician and hospital records and assesses accuracy of available documentation in ER records in comparison to descriptions of assigned Current Procedural Terminology (CPT) codes provided by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA). Our capabilities include identifying strengths and weaknesses of client's physicians through available documentation and evaluating records for compliance with government payer regulations.

Detailed subject matter analytics

A/R Analytics Solution

Through the creative combination of advanced technology and qualified and experienced billing professionals, we can improve cash-flow and reduce days in A/R ensuring that our clients get paid more, faster and at a much lower cost.

Some of the key highlights from our A/R Follow-Up Solution includes:

Receivable Analysis		Resubmission of Cliams
Low per claim processing fee		Secondary Claims Submission
Payer Follow-up		Detail Reporting
Denials Management

Key Benefits

Improved cash-flow		Higher Customer Satisfaction
Reduced A/R days		Can easily handle new clients without adding staff or new infrastructure.

Content Management Solution

We are pleased to offer our clients the benefit of our content management solutions, which affords them the opportunity to build a 'savings pipeline'. This enables the creation of automated and repeatable processes to drive year on year savings through accurately classified spend data. Rusan content management services help clients identify savings and compliance opportunities resulting in the following advantages

	Creation of global spend visibility
	Generation of savings and compliance
	Maximized return on investments

Spend Management Analytics

Spend Management Solution creates a spend management infrastructure that dovetails Strategic Sourcing and Supplier Relationship Management by:

	Reducing spending
	Increasing procurement compliance
	Rationalizing suppliers
	Manage categories
	Tracking savings mandates

Spend Analytics Solution gives our client global spend visibility. We help organizations create automated processes to classify spend data and identify savings opportunity. In return the business generates more savings and gets maximum returns on investments.

	Remote front desk management
	Complete coding and billing solutions suites

Medical Coding Solution

With several years of expertise on both physician and reimbursement sides, our highly dedicated team of CPC and CPC-H outpatient facility certified coders from American Academy of Professional Coders (AAPC) ensure highly accurate and compliant coding services. Our two certified extremely experienced PMCC trainers oversee daily operation of our Coding department and see to it that all industry standards and compliances needs are met.

The coding process includes the following steps:

	Patient documents / files / reports that are electronically scanned at our client's office are seamlessly and securely accessed by our offshore center using our value platform VPNS connections.
	Our teams verify and validate the documents, split them into batches and review them for completeness, quality and readability.
	Diagnosis, Procedure Codes and modifiers are assigned as per client descriptions and guidelines. Modification of certain codes may be made as per carrier requirement (e.g. certain insurance carriers require ASA code).
	Our diligent auditors and Six Sigma oriented quality control team audit the coded charge sheets and process it further for charge entry and cash posting

Medical Billing

We do billing for Physicians in all specialties across United States.

We care for our clients, no matter if they are physician or billing companies.

We take pleasure in delivering quality services with high caliber to maximize the Practice revenue.

We are fully equipped in Revenue Cycle Management for Physicians or for Billing Companies. We are also flexible to render our services in modules.

Need for Strategic Alliance

We have a complete blend of manpower such as Super Bill Executives,

Account Receivable Specialists, Payment Posters and Denial Management Analysts.

You can concentrate on the Core Job while your billing is handled effectively by us.

Assured Increase in Revenue…

Investments on infrastructure, technical components, etc not necessary.

Investments on infrastructure, technical components, etc not necessary. Lesser Hassles (No Recruitment Challenges or No HR related issues. We take care of PF, ESI and all other government related matters).

Uninterrupted work flow irrespective of worker’s strike, lay-offs, absenteeism, absconding, local holidays, power cuts, etc.

Maximize your Returns on Outstanding Receivables...

Reduce your days in AR and thereby Faster Reimbursement…

Quality Output …

Reduce Your Billing Staff Requirement...

We provide a systematic and effective training to our associates.

Improve Office Moral…

Thus Increase your Profitability and your potential to expand.

Billing Service We Render

Provider Credentialing

Data Reception

Demographic Management

Charge Entry

Clearing House Management

E-Claim Submission

Paper Claim Submission

Handling ERA

Payment Posting

Denial Posting

Denial Management

Accounts Receivables

Appealing

Generating Patient Statement

Patient Calling

Billing Service We Render

Patient Appointment Calls

Provider enrollment

Medical Transcription

Data Security & Confidentiality

We at Rusan Medisys Pvt Ltd understand the importance of maintaining the confidentiality, security of client’s data and PHI. We have physical, administrative and technical safeguards in place to ensure data security and scrutiny

Medical Billing Process

We believe that the whole process revolves around having efficient staff who understands that the most important thing about medical billing and collections is information. Proper information gathering is the most important step. The process starts at the front desk. We have given a brief explanation below on how our process works. Please contact us if you have any further questions.

1. Pre-certification & Insurance Verification

The patient list, a copy of the insurance card and demographic details are sent to us via email/fax or secure FTP. Our medical billing specialists call up the insurance company prior to the appointment. Pre-certification is done for specific lab tests, diagnostic tests and surgeries. The details are sent to the hospital/clinic in the prescribed format.

2. Patient Demographic Entry

The medical billing specialists enter patient demographic details such as name, date of birth, address, insurance details, medical history, guarantor etc as provided by the patients at the time of the visit. For established patients, we validate these details and necessary changes, if any, are done to the patient records on the practice management system.

3. CPT and ICD-9 Codin

Our coding team consists of AAPC certified coders with over 2 years of multi-specialty coding experience. You may send us super bills with diagnostic notes with or without ICD and CPT codes. If codes are already provided on the super bill, they are validated by our coding team compulsorily to prevent any ‘up-coding’ or ‘down-coding’ and therefore, any denials.

4. Charge Entry

The fee schedules are pre- loaded into the practice management system. CPT and ICD-9 codes are entered into the system. The billing specialists ensure that all details have been provided in the claim and ready to be filed..

5. Claims Submission

Claims are submitted electronically via the practice management system. However, we can process paper claims also. At this stage, a thorough quality check is done by a senior billing specialist and then submitted. The rejection report received from the clearing house, if any, is analyzed and the necessary changes are done. These claims are then resubmitted.

6. Payment Posting

Scanned EOBS and checks are sent to our team. All payments are entered into the system. The amounts from EOBs/checks and amounts posted in the system are reconciled on a daily basis. A daily log is updated with these data.

7. Account Receivables Follow-up

All claims in the system are examined and priorities are set. First the claims close to their filing limits, and then work down from the age of the claim. Periodic follow-ups over phone, email and/or online is done to get the status of each claim submitted to the insurance company.

8. Denial Management

Analysis of denials and partial payments is done by our senior medical billing specialists. Payers, patients, providers, facilities and any other participants are called to follow-up on denied, underpaid, pending and any other improperly processed claims and the action is documented in the system. We will call patients, if authorized by the provider, to obtain information from the patient needed for billing such as ID# and to update the COB (Coordination of benefits) with their insurance companies. Secondary paper claims are processed and sent to the client office for submission.

At Rusan we guarantee to offer superior solutions.