We bring in the medical world to your home

We change the medical world by proving the best service at Q Way

QWay TechnologiesServicesHealthcare Business Process Outsourcing

Healthcare is one of the industry BPO growths through 2014. According to the survey, there is a huge demand for benefits administration BPO in the US due to the changes in healthcare legislation. Changes that take place across the Healthcare industry are marked by Work Environment, Reduction in Cost of Care, Accountability for Care outcomes, Efficiency and Transparency. These changes demands the constituents of Healthcare delivery namely Payers, Providers, Medical Devices Companies and Managed Care Organizations to re-organize themselves for the future.

healthcare-business-process-outsourcing

Why Q Way BPO?

Q Way BPO has long lasting relationships with Healthcare and Insurance Organization offering services across the payer, provider and medical devices value chain. Q Way BPO has been serving a variety of services to our client through Efficient Services to Consumers, Sales Partners and Providers, Increase cash flows, speed to market, improved compliance and fraud prevention service.

Key facts:

  • Offerings across Healthcare Payers, Providers, Distributors and Medical Devices
  • We have associates across India & US delivery locations
  • Process over million claims per annum
  • Handle million Provider & Member calls per annum
  • Standard Remote Health Monitoring

Q Way Technologies is mainly focused on the US healthcare business, working with the medical billing companies and physicians across the United States.

Our bottom-line is to provide the best in class quality service and a cost effective model for the complete Revenue Cycle Management.

We have expert level experience working for multi-specialties and major billing systems.

A/R ANALYSIS & FOLLOW-UP

The most risk factor that affects the productivity and sustainability to the maximum is bad AR management for the parties involved - medical billing company, doctor or a practice group. This is a situation due to inappropriate claim filing or unplanned follow-ups, which leads to lack of cash flow and thereby increasing frustration level and a threat to your overall efficiency.

The biggest differentiator from Q Way versus any other medical billing outsourcing company is the fact that we always think in the shoes of the doctor or the group of physicians. This approach helps medical companies to alleviate undue pressure of redundant training, communication burdens and educating working strategies to the outsourcing vendors. Q Way acts as a partner with a medical billing company as being a part of the local billing team.

We look into the aged ARs for reasons and resolutions. Relentlessly look for avenues to identify and enhance overall efficiencies within each process and look for ways to collect money. We are well aware of the process. That’s why Q Way's hit rate is stern at 100%.

With highly skilled associates and cutting edge technology, we can enhance provider's revenue and sequentially increase your organization's bottom line by payment processing; reducing days in A/R, claims submission improving collection ratio and increase the probability of payment through timely follow-up. We have individual teams to dissect the ‘new’ and ‘old’ ARs separately.

What Q Way does to medical billing companies?

  • Dedicated and expert team for all the processes in the revenue cycle
  • Significant AR Analysis and follow-up processes.
  • Higher AR collection rate at incredibly low costs.
  • We present weekly and monthly reports and dashboards on AR collections
  • Frequent communication and set up scheduled meetings.

MEDICAL CODING

At Q Way, we believe in seeing what our client see. We always listen keenly to our clients and provide insights as needed. This combination is done to retain excellent customer relationship. Our medical coding experts utilize various coding techniques and specialized software for avoiding duplication and other coding errors. Our efficient medical coding solutions permit clients to invest more of their time and budgets in their core business activities.

Our medical coding service with experts has huge knowledge in coding, compliance and other re-imbursement rules related to government and private insurance payers as well. At Q Way, we stay at the upper edge of technology ever. We know our customers requirement. That is for this reason that we one of the most sought out service providers in the US healthcare industry.

Medical coding that includes:

We perform instantaneous code checks to confirm each and every claim against the government coding standards and other payer-specific reimbursement rules and regulations. Our instantaneous code check includes:

  • ICD-9 coding
  • ICD-10 coding
  • CPT coding
  • CPT / HCPCS code and modifier evaluation

Q Way coding team is headed by Doctor (CPC. CPC H and CPC P certified). We are exceptional enough to pre-adjudicate before submitting your claims to the insurance companies. Turnaround time is 12-24 hours.

DEMO & CHARGE CAPTURE

Capturing information like patient's name, residence address, city, state, zip code, social security number, employer details and insurance details (like primary, secondary, tertiary and guarantor information etc…). It is concluded by the next business day morning.

PAYMENT POSTING

Q Way's payment posting solutions save valuable time, improve data accuracy and accelerate the flow of money into the proper accounts.

Daily deposit is balanced accurately.

Denials are worked immediately and secondary claim reports are sent on a daily basis.

For partial payments, analysis is done and corrective action is taken.

DENIALS MANAGEMENT

With customized denial tracking reports, we follow up on denied claims with minimal, prioritized work lists. We can easily determine why the carrier rejected your claim, and then gain the ability to set up an automatic reason-based work list for efficient follow-up, maximizing your chances to obtain approval. We also understand that achieving powerful results from denial management requires data, data and more data. Our denial management processes reports and measures all claims that are being denied by your prayers.

We will help you in optimizing the claim to avoid rejections and denials. The claim is compared by the team against the standards to avoid health plan rejection and denial defender verifies modifier usage, checks for CCI bundling edits (CMS National Correct Coding Initiative), determines code validity, displays relative value units (RVU), validates pass-through items and verifies medical necessity.

REFUNDS PROCESSING

We ensure patient satisfaction through timely and effective processing of refund requests; responding to communication from third-party payers with requests for refunds; reviewing, auditing and processing accounts in credit balance modules identifying accounts for which a refund is owed. We resolve account discrepancies by auditing account detail; processing void and stale dated patient and insurance refunds.

CREDIT BALANCE

Complete document for verified overpayments is retained in our office. We bring you a monthly listing for refund checks.

CLEARING HOUSE REJECTIONS

We believe that our medical billing service is more than just adjudicating claims; it is about providing small services necessary to help make your practice more efficient. We work on rejections and fix it as early as 12 hours.

RETURNED MAIL PROCESSING

The foremost benefit of using Q Way clearing house is that it can help you reduce the amount of claims rejected by the insurance companies and can speed up the time between submitting a claim and being reimbursed for your services. Our service makes sure that your staff doesn't waste the productive time on the phone with the insurance provider for hours trying to find out a resolution.

INSURANCE VERIFICATION

Insurance verification is one of the most important aspects of medical billing services as it plays a major role in denial management In order to avoid claim denials and rejections. Patient’s insurance verification must be acquired prior to the point of service. Verification basically deals with securing written or verbal confirmation of the insurance coverage of the patient’s insurance company. Applicable medical insurance verification can prevent unnecessary claim denials for healthcare practices.

Patients often provide incorrect or outdated insurance information. There are times when their policy has been altered or modified in some way. This is therefore important to verify this information at each and every visit. Q Way can help healthcare providers focus on their core functions by effectively handling their patient information verification responsibilities. As part of our patient eligibility and benefit verification services, we ensure that all gaps and information errors are spotted before claim submission. We make sure that you claim are clean.

We get the insurance details of the patient and carry out online verification or call the insurance payer. The details we verify include:

  • Primary and secondary payable benefits
  • Patient details
  • Pre-authorization number
  • Co-pays
  • Co-insurance details
  • Deductibles
  • Patient policy status
  • In network and out of network benefits
  • Effective dates
  • Plan type and coverage details
  • Plan exclusions
  • Required Referrals and pre-authorizations
  • Claims mailing address

Medical Insurance Verification process involves the following steps:

1) Maintaining accurate patient’s record
2) Requesting patients insurance card and photo id
3) Contacting the insurance through phone or website
4) Obtaining co-pay information
5) Contacting insurance for uncertain aspects
6) Verifying secondary and tertiary insurance information

Our insurance verification services are intended to ensure clean claims for improved cash inflow. By obtaining the latest benefits and eligibility data, we can contribute to increasing the rate of clean claims and help you save up to 30% to 40% on your operational costs.

CREDENTIALING

Provider credentialing is the first step in the revenue cycle development. Claims cannot be submitted until the insurance carrier approves the provider. Credentialing a time consuming and tedious task.

Q Way Technologies employs dedicated credentialing specialists. Our credentialing is completed accurately and efficiently.

The credentialing process is a time consuming and labor intensive. Q Way helps streamline the process by completely fulfilling the payer needs to avoid rejections of application by the payers.

  • Initial Credentialing for provider and Group.
  • Re-Credentialing for providers.
  • Adding new providers in the group.
  • Removing existing provider from the group.
  • OBH certification including police check for LA providers.
  • Submitting Medicare application via PECOS.
  • Getting CAQH provider access.
  • Complete electronic applications (CAQH updated every three months)
  • Maintain an electronic provider database
  • Tracking applications until it's completed by payers
  • Re-credential application submitted as required
  • DEA/CDS registration.
  • Hospital Affiliations.
  • Professional Liability Insurance certification.
  • NPI registration
  • CLIA registration.
  • Application Re-validation.
  • NPDB registration and reports.

As regulations state and federal requirements change constantly. We stay current with these regulatory requirements to make sure that our client maintains the proper compliance.

Advantages of Q Way Service:

  • Ease of submitting and retrieving documents
  • Faster reimbursement
  • Strict confidentiality
  • Faster turnaround time
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