With expertise

Healthcare Business Process Management Service

IntelliRCM, a brand of Mangalam Infotecch USA, is a comprehensive Revenue Cycle Management solutions provider to the Healthcare Industry. Mangalam, with over 20 years of experience as a Business Process Management company, possesses extensive and robust capabilities to support Medical practices, Hospitals, Pharmacies and Laboratories and help streamline and enhance their Medical Coding, Billing and Collection services.

We also offer a diverse range of other value-added services like Credentialing, Medical Transcription, Patient Engagement, Document Indexing, Authorisation, Fax & Document Management services.

Benefits our clients receive from our services:

  1. Reduced staffing and overhead cost
  2. Enhanced quality in the billing process
  3. Increased collections
  4. Reduced rejections and unreimbursed claims

We leverage our efficient processes and modern technology to maximize our client’s financial and operational performance, patient’s experience. We help our clients concentrate on their core competencies in a cost-effective manner.

Revenue Cycle Management Services

It is most critical aspect of revenue cycle . Our experts verify patient’s insurance to the coverage details, coverage period, co-pay amount, deductible and benefits information. Accurate checking can reduce denials and appeals can be minimised as it has got a direct impact on overall revenue of the practice.

Our medical coding services enable you to cope with coding demands, smoothens the medical billing process and improves cash flow management for inpatient and outpatient healthcare providers. We access the superbills and detailed patient information from the physician's office through a secure network and the certified coders provide CPT and ICD coding., The coded documents are checked by the medical coding manager. Our coders are very well versed with the changing nature of the regulations and adapt their work accordingly, ensuring accurate results.

The charges from the coded documents are entered the patient account. In case of the new patient, the account is created by entering all the demographic details from the patient registration form. Quality Assurance (QA) team to ensure that a 'clean claim' is submitted.

Once the charges are entered and audited, the claims are then filed with the payer electronically. In case of any error founded at gateway of the clearing would be recent within 24 hours .Our workflow technology and automated audit processes help to reduce turnaround time, increase processing quality and accuracy.

Once the claims are submitted to the Insurance company for processing, A/R team resolutely keeps tracks ageing and pursues all unpaid insurance claims that have crossed the defined period, and follow-ups are prioritised based on the value. In case of the underpaid claim, steps are taken to ensure that the underpaid claims are processed and paid correctly. We also follow up with the patients to pursue any outstanding balance that is still pending after processing of the claim.

Insurance Company either sends an EOB (Explanation of Benefits) or ERA (Electronic Remittance Advice) towards the payment of a claim. The medical billing staffs post these payments immediately into the respective patient accounts, against that claim to reconcile them. The payment posting is handled according to client-specific rules that would indicate the cut-off levels to take adjustments, write-offs, refund rules etc.

The denied claims are addressed on priority basis - our billers and coders find the missing puzzle pieces fast, and re-file or appeal the denial. We have Denial Analysts on board who fix the issue and send the claim for reprocessing. If the claim needs more information from the provider, then these gaps are filled promptly; if the claim is denied and the patient is responsible, the claim is billed to patient.

We can provide customised reports based on your requirement. The standard reporting package contains monthly customized reports, including insurance aging reports and Key Performance Indicators (KPI) report, offering a detailed picture of your practice's financial health and the length of your claim payment cycle.

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