Saven has qualified and well trained people in the medical billing segments for complete billing cycle solutions. Saven has the expertise to support :

• Acute care facilities

• Clinics

• Hospitals

• Individual physicians

• Long term care facilities

• Multi specialty groups

• Physician groups

End-to-end process of billing will be done for all the facilities

Processes/Activities undertaken at Saven are detailed below:

Patient Registration

Patient Demographic entry is done wherein details pertaining to a patient are entered into the database containing:

• Patient information

• Employer information

• Insurance information

• Guarantor information

Insurance Eligibility verification

Eligibility of the patient with the insurance company is checked either thru IVR or online

• Policy ID

• Effective dates of insurance

• Guarantor details

• Patient relationship with the guarantor

• Secondary insurance information

Charge postings

Creates charges with the help of super bills/encounter forms, where information pertaining to physician and treatment details are captured in the database containing:

• Date of Service

• Referring Physician

• Attending Physician

• Place of Service

• Procedure Codes

• Diagnosis Codes

• Modifiers

• Authorization or Referral

• Co-pay amount.

Claims submission

• Claims created are transferred to patients’ respective insurance company either electronically or through paper

• Secondary insurance claims will also be filed on paper along with the primary Explanation of benefits (EOB)

• Electronic transfer of claims help our clients to get the payments quickly

Regular insurance follow-up

If the claims are not paid within the stipulated period, our team members

• Initiate the process of outstanding claims

• Follow up with the respective insurance companies

• Applying corrective action at the source of identified problem

Saven also maintains the up-to-date information released periodically by the US Government – Healthcare department.

This enables the team to follow all the latest rules and regulations in medical billing, for prompt and maximum payment for the services done for its clients.

Posting payments

Saven records payments received by the Service providers’ office directly from patients or through checks from the insurance company towards the charges.  Saven also checks for partial payments and take necessary action.

Saven also maintains the following records on claims:

• Check details

• Amount paid

• Allowed amount

• Co-ins amount

• Write-off amount

• Transfer of balance to next responsible party

Periodic reconciliation of cash received is carried out and reports provided to the Doctors

Denial management

Saven’s denial management team takes action by

• Tracking denials along with denial codes.

• Analyzing Credit balances and processing it..

• Identifying accounts and submitting to the insurance companies.

Provider enrollment and credentialing

Saven does the Provider verification with the major insurance carriers to identify and get updated

• Tax ID number

• PIN number

• Group number

Necessary documents are submitted to the insurance companies for enrolling.

Customized management reports

Saven generates periodically a number of reports relating to the activity for the benefit of Doctors and/or service providers. Most commonly used reports are

Financial Reports (for any desired period) on:

• Aged trial balance, by payer type or by payer

• Activity reports by provider/facility which show charges, payments & adjustments

• Patient transaction history

• Procedure codes, by provider, with comparison to historical data

• Diagnosis code analysis, Referring Provider Analysis

Activity Reports

• Claims and payment tracking by Date of Service, date posted, or date payment received.

• Payments by user, date posted, date received or accounting period date

• Full transaction analysis by user and/or by patient

• Procedure codes, by provider, with comparison to historical data

• Diagnosis code analysis, Referring Provider Analysis

Reimbursement Analysis

• Reimbursement by procedure code and payer, including % of collections, and % of Medicare fees

• Claims and payment tracking by Date of service, date posted or date of payment received

• Payments by user, date posted, date received or accounting period date

• Full transaction analysis by user and/or by patient

• Procedure codes,  by provider, with comparison to historical data

• Diagnosis code analysis, Referring Provider Analysis.