Commonly outsourced tasks in healthcare and life sciences
What tasks should I outsource? Sample tasks we help perform for Clients:
General Nursing:
- IV Nursing SOC calls & compliance survey
- Medical Necessity Documentation faxing orders to agencies;
- SHP reporting;
- sending Auth requests
- IV New Referrals Master list
- Confirming AIS appointments.
- Initial Medical Necessity Documentation
- Tracking Nursing Agency visits and Communication with Nursing Agencies
- Confirming visits AIS
- Processing nursing agency visit notes
- Handling SNV and flight invoices
- Communication with Nursing Agencies
- Tracking Nursing Agency visits
- Creating billing packets
- Confirming Nursing agency visits in clinician visits & process for billing.
- Confirming home visits home
- Specialty Infusion care plans with auth info
- Specialty Infusions tracking expired auth & Rx
- Processing of 24hr Intake referral form (calling patients to verify information, calling MD offices, assigning faxes and sending receipt of Referrals)
- Manage incoming patient phone calls to ensure >95% answer rate
- Following up on Specialty packets
- Rx refills & Consent Forms.
- Checking Insurance Eligibility (HME/IV bucket list)
- Generating authorizations (all insurances)
- Communicating to Insurances via fax/phone call
- Authorization tracking
- Stop loss checking & Nutrition On call support
- Enteral refill calls and delivery tickets
- Oral refill calls and delivery tickets
- Management of Incontinence/Oral New Referrals.
- Generating statements of medical necessity for Incontinence Therapy & Request for additional information (MD office calls).
- Start of Care follow up calls
- MD calls to follow up outstanding SMNs
- Clinical packets & Continued Medical Need & Request for additional information (MD office calls).
Revenue Cycle:
- Insurance calls and open claims
- Correcting denied claims
- Sending corrected claims
- Managing Patient statements
- Managing Denials
- Checking claim statuses online
- Process refund Request
- Insurance notifications & correspondence
- Write-off/void/patient clean-up & facility statements.
- Billing AIS(reviewing before submitting)
- Posting for all Credit cards/Checks and cash payments
- Payment postings for insurance payments
- Payment postings for Central Pay
- AR Spreadsheet month end closing
- Prior Authorization
- Eligibility Verification
- Credentialing
- Fee schedule maintenance
Accounting
- Bank Reconciliations
- Journal entries & Reports
- AP Vendor management
- Statements Monitoring
- Preparation of Bergen Invoices
- Import File & Financial Statement Analytical Review
- Prepare VD-Weekly AR Cash Deposit Report
- Manual Invoicing & Financial Statement Preparation
Data Analysis
- Weekly SPC Active & New Referrals
- Weekly reporting: Profitability Report, Infusion Bucket Tracking Presentation, Secondary’s & Poster Report, Delivery Report; Unbilled Tickets & Unbilled Sales; Driver’s date; Weekly Profitability Report; Nutrition Productivity Report and DTs Breakdown;
- Executive Summary Presentation;
- Monthly & Quarterly Presentation.
- Executive Summary
Central customer service line
- Manage incoming and outgoing calls for customer service across a range of product types
- Patient scheduling
- Check in and follow ups
- Call routing
- Miscellaneous customer service requests
- Tier I-III Help Desk Support