phoenix & york ites presentation

Phoenix & York Business Solutions Limited

A VALUE DRIVEN SERVICE COMPANY THAT UNDERSTANDS BUSINESS

Presentation

Confidential - Copyright - Phoenix&York @2007

Presentation

About Us

• The IT and ITES Consulting arm is based at New York with Global delivery centre in Chennai, India

• Backed by Industry Stalwarts & Experienced Top Management with very strong IT Industry credentials & huge

experience curve in Servicing Fortune 1000 Clientele across the globe

• Highly Qualified, Trained and Empowered Team

• Process Capability, Maturity

• Operational Efficiency & Optimized Productivity and customer-centric approach results in Repeat Business.


• World Class Infrastructure with state of the art Security, Reliability

• Service-Oriented Architecture (SOA) which ensures that global Clients SLA’s are met within the stringent

deadlines.

• Sustained Growth, satisfied Clientele

• Systematic and Professional Approach backed by International Management Team

• Flexible, Adaptive in Approach, Impeccable Delivery Mechanism and Personalized Service.

Service Model

• Management Modes

- Time and Materials (Customer Managed)

- Turnkey (Phoenix & York Managed)

- Hybrid (Onsite – Offshore )

• Pricing Modes

- Time and Materials ( Effort Based )


- Time and Materials ( Effort Based )

- Fixed price ( Milestone Based )

- Fixed Transition Earnings

• Our Models are

- Flexible

- Adaptable

- Scalable

- Open to Innovation

� Medical Billing / Coding

� Demographics & Charge entry

� Audit

� Coding

� Insurance eligibility verification

� Claims transmission

� Cash posting

� Analysis

� Calling ( Insurance/Patient )

� Month end reports

� Healthcare Insurance forms process

Services - ITES


� Mail processing services preparatory to scanning

� Document scanning

� Offshore data entry with high quality output

� Archival & Storage

� Document management

� Scanning, imaging and indexing

� Systems and system support

� Data management

� Data preparation, capture and enhancement services

� Database building and management

� Accounting / Financial Services

� Transaction entry

� Journal entry

� General ledger

� Assets / equipment ledgers

� Expenses ledger

� Accounts receivable services

� Accounts payable services

Ageing report & summaries

Services - ITES


� Ageing report & summaries

� Payroll processing

� Bank account reconciliation

� Financial statements preparation

� Trial balance

� Income statement ( Profit/ & Loss )

� Balance sheet

� Cash flow statement

� Audit

� Demographics & Charge entry

� Our trained Medical Billing Professionals will enter personal information about the patient from the

demographic sheet.

� The team will then check the relationship of the Diagnosis code with the CPT.

� A change will then be created according to the billing rules pertaining to specific carriers and locations.

� All charges will be accomplished within the turnaround time agreed with the client, which is generally 24

hours.

� Audit

� The daily charge entry will audited to check the accuracy of the entry based on carrier requirements to

ascertain a clean claim.

Medical Billing / Coding


ascertain a clean claim.

� Coding

Our Medical Coding service enables individuals and Hospitals to file a claim with the patient's

health insurance provider, managed care organization, or government entities.

Our These codes help medical insurance and others to understand what was wrong with

the patient, whether treatment was necessary and what services were administered.

All these codes help non-medical staff at the insurance company and other health service providers to

handle the claims and make payments on a predetermined basis. Our specialty is ICD-9, CPT, HCPCS

outpatient (physician) coding for the CMS-1500 /2000 form.

� Claims transmission

� Claims will be filed and relevant information sent to the Transmission department.

� The operations team will then prepare a list of claims that are transmitted electronically. Once the claims are transmitted electronically, confirmation reports will be obtained and filed after verification.

� Paper claim will then be printed along with attachments and dispatched to insurance agencies.

� Finally, transmission rejections will be analyzed and appropriate corrective action will be taken.

� Cash posting

� The cash posting team will receive the copy of check and EOB.

� The team will then apply the payments in the billing software against appropriate patient account.

� During cash application, overpayments are immediately identified and refund requests are generated.

� The analysts will then be informed of underpayments and denials.



� Analysis

� Account receivable analysts will research the claims for completeness and accuracy. The AR analysts will then set orders about making calls from the call center.

� The analysts will also research denied claims, rejections received from clearing houses and low payments by carriers. After this research is completed appropriate action will be taken.

� Calling

� The call center executive will call the insurance agency and verify current status of the claim (whether it is being processed for payment or is being denied).

� Based on the claim status, the analyst will get the pre-requisites needed. If the claim is being processed for payment, a list of payment details will be compiled. If denied, corrective action will be initiated.

� The Call Center Team will receive work orders from the analysts. The Call Center Executive will then initiate calls to the insurance companies to establish reasons for the non-payment of the claims. All such reasons will be passed on to the Analysts for resolution.

� Month End Reports

� At the end of the month, Phoenix & York will run procedure code usage reports and aged summary reports to asses what has been achieved for that particular month, and also to identify patterns of non payment if any.

� If any claim is found to be older than 60 days, immediate action will be taken. Any claims pending for clarification will be passed on to the respective account manager for remedial action.

� Insurance eligibility verification

Patient Eligibility check is made online through Insurance websites to check benefits, Effective date of Policy



� Patient Eligibility check is made online through Insurance websites to check benefits, Effective date of Policy etc.

� We also have a specialist Team that verifies Benefits by calling the Insurance companies

� This process would ensure cleaner claims being submitted to the appropriate Insurance companies.


� Specialties

Phoenix & York professional team, which is innately capable to ramp up in short notices, possesses a wide

variety of skills and can perform variety of roles.

Phoenix & York has experience in the following specialties.

� Family practice

� General practice

� Gynecology

� Internal medicine

� Neurology

Nephrology


� Nephrology

� Obstetrics

� Psychiatry

� Pulmonary diseases

� Radiology

� General surgery

� Physical therapist

� Pediatric

� Pain management

� Account Receivables

Phoenix & York can help in following up pending claims, initiating collections, tracing the reasons for claims denials, tracking outstanding receivable balances by customer and by the date when payment is due, providing periodic reports and more.

� The claims get denied mainly due to:

� Duplicate claim

� Additional information needed to process the claim

� Incorrect or missing CPT procedure code

� Physician’s name and/or UPIN missing or incorrect

� Incorrect or missing place of service code



� Phoenix & York can

� Reduce average days in accounts receivable

� Reduce write-offs from bad debt

� Reduce claim denials

� Improve your cash flow

� Increase your revenue by up to 40%

� Improve customer service and patient relations

Insurance Forms Process

Phoenix & York offers end-to-end healthcare insurance administrative services. Phoenix & York provides

Health Insurance Forms Processing services, from HCFA /CMS 1500, UB 92 and Dental forms in different

formats.

Our Services include:

� Mail processing services preparatory to scanning

� Document scanning

� Offshore Data entry with high quality output

� Archival & Storage


Phoenix & YorkPhoenix & York ensures 99% accuracy in data conversion to prevent payment errors down the line.

Insurance Forms Process - Diagram

Download folders containing Scanned Images

FTP Serv

er

Local Serve

r

Distribute

Scanning

Convert into

Electronic Format

Client

Insurance Forms from the Client


Distribute

image to the

Pro Asst

Capture the

required fields

QC

Document management

Document Management (Onshore):

Phoenix & York can provide a range of services to manage the handling, sorting and preparing of paper, microfilmand microfiche prior to image conversion. The range of imaging services includes:

• Image capture

• Indexing

• Optical storage

• In-house or remote access and viewing

• Multi-site and multi-user access and viewing

• Image processing

• Image retrieval

• Interface to workflow or in-house systems


• Interface to workflow or in-house systems

• Provision of in-house managed services

• Provision of document imaging systems.

Data Management Services

Capture and enhance

The data capture services of Phoenix & York brings international resources and over several years of experiencein the digitizing, processing and management of data. The company employees highly skilled specialists providingan aggregate capacity of over one billion key depressions per day. The services include:

• Project specification

• Document receipt and preparation

• Manual editing and coding

• Key from paper, microfilm, microfiche and image

• Optical Marks Reading (OMR)

• Optical Character Recognition (OCR)

Data management


• Optical Character Recognition (OCR)

• Image Character Recognition (ICR)

• Data output (to tape, disk, CD, mainframe or on-line)

Database Management

Capturing data to specific instructions alone does not always provide the end customer with the desired result to complete the process. Phoenix & York provides a range of Data Cleansing and Data Querying services to process keyed data. This service includes:

• Offline validation of keyed information using external tables

• Application processing with data irrigation and intelligent transcription

• Database construction and migration using human intelligence

• Database management

Accounting/Financial services

Account/Financial/Bookkeeping Services

Phoenix & York is a preferred supplier to many large financial services organizations providing value added

services in supporting its back office operations. The company has made significant investment in people, process

and technology to provide its customers with a suite of services in HR processing and back office accounting

services. The company has a proven track record in handling:

We have a very user friendly process in place. You can send your paper documents through an e-fax or by

scanning & emailing it. Once we receive the scanned image of the document, it is filed in a document

management system & the transaction is posted in the accounting software of your choice .

We can update your books with in 24 hours Turn around time. This can be carried out by using QuickBooks back

up. We upload the updated books on to a secure server.


up. We upload the updated books on to a secure server.

There are three options for using the Accounting package.

• Using an ASP version.

• We can host a server in our centre or a web form, with restricted access.

• We could log in to your server & post the entries.

� Bookkeeping Services Includes

� Computerized processing of all checks and bookkeeping information.

� Bank statement reconciliation.

� Preparation and review of monthly financial statements.

� Maintenance of employee and sub-contractor earnings records.

� Preparation of all payroll related tax returns.

� Preparation of year-end W-2 and 1099 forms.

� Day-to-day bookkeeping and accounting.

� Books balanced and reconciled quarterly.

� Management accounts produced quarterly.

� VAT returns produced quarterly.

� Annual accounts and tax returns preparation.

Accounting/Financial services


� Annual accounts and tax returns preparation.

� Submission to Inland Revenue.

� Submitted to Companies House.

� Expert tax advice to minimize tax liability.

� Adjustments to year-end accounts.

� Storage of documents at our offices

Advantage

Phoenix & York Guaranteed

• Measurable benefits

• Cost savings

• Guaranteed quality

• Faster closure

• Focus to grow the business

• Better books, better profits

• Security of your data


Security of your data

• 100% accuracy of your data

• 24/7 communication

Infrastructure Management

Server

Management

Network

ManagementOS & Applications

Cisco Compliant

Routers, Leased Links,

LAN & Firewall

Domain, Ftp, Production with

Server Rack, Windows 2003

Server Environment

Windows XP, Windows Vista,

MS Office & Image tool

Remote Desktop Mgmt

Daily Event Log,

Patch Mgmt, Policy admin


Managed Security Services - Firewalls, IDS, Anti-Virus, Virus Scanning, Network Scan for Security etc

Physical Security – Bio Metric Scan ID for All Employees, 24/7 Physical Security Service, Bio Metric Scan ID for All Server

Rooms, CCTV, Fire Protection, E-Centrex Communication System for All Employees, Disaster Recovery offsite Center

Contact Details

Global Delivery Centre

Ispahani Center, 123/124, Nungambakkam High road,

Chennai – 600034

Tel – 91 44 66141602/ 91 9940676954/ Fax: 91 44 66141602

Raja ruban ( Head of IT enabled Services

[email protected]

Web: www.phoenixyork.com
