All the relevant documents for processing are first assimilated by the ICEGEIN
Pre-Verification Team.

This includes:

Patient verification

Basic information about the patient made easily accessible/retrievable by capturing identity details of the patient on the basis of

Appointment Date

Name

Date of Birth

Social Security Number

Insurance details

Employment details etc

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Incorporate Procedure codes, Diagnosis codes, Modifiers and other related information into the Billing Software.

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ICEGEIN has a sophisticated billing management system that ensures accurate coding using ICD9CM and CPT Books, following AMA and LMRP guidelines.

All Coded Charts are audited for adherence to coding rules and regulations. All the operations adhere to standards set by the HIPAA regulations and done according to the AAPC ethics.

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To ensure accurate application of data received from the insurance companies on receipt of payments, ICEGEIN uses advanced recording facilities. ICEGEIN also analyzes post payments/partial payments and undertake corrective action. This extends to:

Insurance payment posting

Cash posting for primary insurance payments/ adjustments/ transfer co-insurance to secondary insurance (if available) or patient.

Posting of secondary insurance payment.

Self-Paid posting

Direct payments by the patients to the healthcare provider.

Denial posting

Checking Claims/re-submission of documents like medical records, authorization etc. for claims denied.

Paid claims are received from Insurance companies as EOB (Explanation of Benefits) along with payment details, which are verified and posted in respective patient accounts. The associate then proceeds to nullify every patient account with the payment details, thus, balancing the ledger for the physician.

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To reduce claims rejection and ensure speedy reimbursement, data is entered electronically and submitted as a claim either electronically or on paper (HCFA/CMS 1530).

Correspondence/denied claims are processed on a day-to-day basis.

Unpaid claims are typically sorted by financial class order and ICEGEIN follows-up with the appropriate insurance companies/self-pay patients if requested, to resolve any non-payment issues.

Note: Account Receivables analysis also includes the review of unpaid balances due from patients for services that have been rendered. When charges are collected the AR service becomes nullified.

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Inefficient account receivables can impend cash flows and deplete revenues. ICEGEIN provides services to follow-up on your receipts by identifying patient accounts that require tracking, analyze possibilities for delay, address insurance issues and rectify the same.

Assessment

Running through daily insurance aging reports/claims analysis to identify: Unpaid /Low-paid/ Denied/Rejected Claims apart from Claims that have not been entered in the records.

Analysis

Ensuring availability of necessary documents like
medical records/referrals/authorizations towards claims re-submission.

Appealing for consideration in case of low reimbursement/timely filing of cases.

Separating the claims denied.

Issuing instructions to the callers for follow-ups and status reports.

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ICEGEIN's Data Validation team checks all the information for data errors/outdated entries and validity before uploading it to ensure 100% accuracy. This reduces underpayments/claims denial to ensure prompt and accurate settlements.

The Auditing Process involves:

Quality Assurance wherein the entire database is validated and each and every entry in the patient demographics and charges are checked

Quality audit entries wherein random checks are conducted to identify errors in patient information.

Charges Entry checkups that run through the CPT/ ICD codes, modifiers, service providers and referring physicians.

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ICEGEIN provides complete reports on:

Transaction volume (Number of Patients and Claims) generated daily/ weekly/ fortnightly/ monthly as requested by the customer.

Incomprehensible files/ charts/ patient information -recorded in log for client clarification and instructions.

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ICEGEIN offers 24x7 help-line with trained callers who can:

Identify patient accounts that require follow-up.

Analyze possibilities for delay.

Follow-up with the insurance providers for speedy reimbursements.

Rectify problems/answer queries.

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