Account Receivables

Some Facts

Account Receivable

0

of total A/R should be less than 90 days

Lost Income

0

is the average cost lost to rework a claim

Claims Processing

0

of denials are never resolved

Account Receivable is one of the pivot departments in Revenue Cycle Management that directly acts on the outstanding receivables to bring the money in. The proactive and aggressive AR specialists at BlissMD Healthcare Solutions understand that only the due diligence of this department helps the outstanding receivables to keep it under control as per industry standards. We have two sub departments under Account Receivables they are

A/R Analytics

A/R Follow-up

Our A/R Analytics and A/R Follow-up services are provided as part of Revenue Cycle Management or as a Stand alone services.

A/R Analytics

Our A/R analyst department works on the objective to reduce AR days and Maximize Reimbursement. AR analysts constantly monitor the receivables to ensure it is well within control and guarantee all the claims are followed-up between 15 – 45 days from the date of transmission or dispatch. The everyday action of A/R analyst follows.

  • Constantly keep tracking both Electronic and Paper claims to avoid any rejections or untimely filing
  • Enquire status on unpaid claims via online tools or Fax request to the carriers
  • Examines ERAs/EOBs for carrier denials and under payment
  • Identify claims for appeal and re submission and initiate the appeals.
  • Forward denied claims with analysis reports, to the appropriate departments for corrective actions and
    resubmissions.
  • Ensure A/R days meets industry standards
  • Reporting as per clients requirement

A/R Follow-Up

Our dedicated and highly skilled AR Insurance telephone crews aggressively follows up on status of claims with various insurance companies, request clarification on billing and reimbursement procedure, and act on work orders issued by various departments needing carrier assistant via IVR and Phone. The A/R follow-up department starts chasing the electronic claims after 15 days from the date of transmission and paper claims after 30 days from the date of dispatch just to avoid untimely filing.

Our A/R Follow-up department helps to obtain the status of unpaid claims, denial and reasons with actions required and status of appeals. Any incorrect denials are explained to the insurance rep during the live call and incorrectly denied claims are sent for reprocessing.

Healthcare providers loose a lot of dollars due to a lack of follow-up on out standing claims with the insurance companies. A/R follow-up team at BlissMD ensures every penny submitted is collected in a timely fashion. Any claims that need to be appealed or pending for additional information are escalated to the respective department to fix it. Our each team of analysts is fully informed on constantly changing billing rules and situations pertaining to specific geographic areas to stay compliance.

Some Routine Issues Fixed Often by A/R Follow-Up team are:

  • Authorization and Referral issues
  • Medical necessity and Medical record request
  • Network Non-participation issues
  • Incorrect/Invalid Diagnosis code
  • Bundled procedure
  • Coordination of benefits
  • Partial payments / underpayments
  • Claim not found
  • Member not found
  • Terminated coverage
  • Other Insurance Primary
  • Out of area claim
  • Workers Comp
  • Reprocessing Incorrect denials by Insurance on live call with the representatives
  • Claims pending for additional information From provider/patient
  • Incorrect check mailing address
  • Refund Request
  • Patient statement queries

Reduce AR days and Maximize Reimbursement

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Neelaveni Jayakumar

Sr. Manager – RCM

Neelaveni comes with nearly 10 years of experience in the healthcare industry spread across home health, In-Patient, Out patient, anesthesiology and radiology environment. Her specific areas of expertise are Revenue Cycle Management and Managed care contract negotiations. Prior to joining BlissMD Healthcare Solutions, she has spent a considerable amount of time working in Banking sector, Life Insurance and Health Insurance companies.

Neelaveni has a solid understanding of all aspects of revenue cycle management with a focus on best practices and expected outcomes to bring and show value at the client level, she has immensely contributed towards BlisMD’s continuous growth, innovation and expansion. Her strength includes client co-ordination, process enhancements and handling escalations, which comes from spending a significant amount of time in managing all billing processes resulting in increased savings and process improvements for the clients she has managed. She has completed a Bachelor’s degree in Mathematics and Science.

Elanchezhiyan A (Dean Mayor)

Founder and CEO

Elanchezhiyan is the Founder and a Chief Executive Officer at BlissMD Healthcare Solutions. He has more than 15 years of experience in US Healthcare industry. Elan created the company in the year 2013 and through his brilliant track record in leadership, management, and operational experience; He made BlissMD a cost effective, client centric, client oriented and most preferred Revenue Cycle Management service provider.

As a CEO of the Company, He oversees the strategic direction of the organization and upholds the company’s position at the forefront of the industry. Under his direction, the Company enjoys a rapid growth and achieves higher rate of customer retention, employee’s satisfaction and add new talents every day.

As a Founder of BlissMD, Elan brings an incredible amount of industry knowledge and relationships that he has built through the years while working in senior management positions in various US-based healthcare services companies. Personally, He is a peace loving Man. He likes playing chess, practicing yoga and Meditation.

Qurathul Zahira

Sr. Manager – Coding operation

As an accomplished healthcare professional with nearly 13 years of experience, Qurathul Zahira has successfully managed the operations, deliverables and audit functions for BlissMD’s coding department. Qurathul has been with BlissMD Healthcare Solutions since its inception. Qurathul is a certified professional coder. She holds a Master’s degree in physiotherapy (M.P.T) and has previously served as a physiotherapist in hospitals and nursing homes. Her Knowledge and understanding of Hospital and Professional fee coding has helped the organization cater to niche demands from clients.

Qurathul is also a subject matter expert of HCC Coding and regulations and this has helped BlissMD support payer side of business. In her current role, She plays a key role in planning overall organizational strategy, growth and customer satisfaction within coding services and Technology. Her client centric work ethic coupled with her focus on streamlining processes has helped BlissMD manage, retain and grow new and existing coding accounts.

Rajiv Manoharan

Sr. Manager – IT and Compliance

Rajiv Manoharan leads the IT and Compliance dept at BlissMD Healthcare Solutions. He and his team acts as BlissMD’s technical safeguards. Under Rajiv’s supervision his team monitors the patient’s electronic ePHI to keep it safe from any threats and control the access to it. He ensures all HIPAA technical safeguard standards are implemented strictly in the organisation without any breach. He ensures his team is kept updated to face any new security challenges.

Rajiv also takes the responsibility of managing full project lifecycle right from accessing the requirements of the project in accordance with the IT strategy, architecture, analysis and building solutions in line with customer requirements, testing, deploy and end-user training (technical and non-technical audiences).

He specializes in IT data security and project management. He has nearly 16 years of experience in the IT and web content management domains and brings in his creative problem-solving and analytical skills to the table. Prior to joining BlissMD Healthcare Solutions, He worked with organizations such as Chettinad Academy of Research & Educations., Dpro Technologies Pvt Ltd, etc.

Revathi R

Manager – Accounting and Finance

Revathi is one of the key decision makers for BlissMD’s over all administration. Revathi ensures the organization is in full compliance with the Law. Under her leadership the company’s Accounting and Finance department executes company’s receivables, payables, payroll, financial controls and financial reporting as per industrial standards. She is a BTech graduate and holds an MBA in accounting. Prior to joining BlissMD, she has spent a considerable amount of time working as a chief accountant in a reputed organization.

As a part of BlissMD’s leadership team, she has been one of a driving initiative to build a skilled and united workforce. She meticulously maintains and up skills the organization’s standards by implementing and evaluating the employees relationship policies and programs. She is known as a high energetic and a positive leader, who loves to face challenges and works smart to achieve it.