Phoenix & York Ites Presentation

Phoenix & York Business Solutions Limited
A VALUE DRIVEN SERVICE COMPANY THAT UNDERSTANDS BUSINESS

Presentation

Confidential - Copyright - Phoenix&York @2007

About Us

• The IT and ITES Consulting arm is based at New York with Global delivery centre in Chennai, India

• Backed by Industry Stalwarts & Experienced Top Management with very strong IT Industry credentials & huge
experience curve in Servicing Fortune 1000 Clientele across the globe

• Highly Qualified, Trained and Empowered Team

• Process Capability, Maturity

• Operational Efficiency & Optimized Productivity and customer-centric approach results in Repeat Business.

• World Class Infrastructure with state of the art Security, Reliability

• Service-Oriented Architecture (SOA) which ensures that global Clients SLA’s are met within the stringent
deadlines.

• Sustained Growth, satisfied Clientele

• Systematic and Professional Approach backed by International Management Team

• Flexible, Adaptive in Approach, Impeccable Delivery Mechanism and Personalized Service.


Service Model

• Management Modes

- Time and Materials (Customer Managed)
- Turnkey (Phoenix & York Managed)
- Hybrid (Onsite – Offshore )

• Pricing Modes

- Time and Materials ( Effort Based )
- Fixed price ( Milestone Based )
- Fixed Transition Earnings

• Our Models are

- Flexible
- Adaptable
- Scalable
- Open to Innovation


Services - ITES

Medical Billing / Coding
Demographics & Charge entry
Audit
Coding
Insurance eligibility verification
Claims transmission
Cash posting
Analysis
Calling ( Insurance/Patient )
Month end reports

Healthcare Insurance forms process
Mail processing services preparatory to scanning
Document scanning
Offshore data entry with high quality output
Archival & Storage

Document management
Scanning, imaging and indexing
Systems and system support

Data management
Data preparation, capture and enhancement services
Database building and management


Services - ITES

Accounting / Financial Services

Transaction entry
Journal entry
General ledger
Assets / equipment ledgers
Expenses ledger
Accounts receivable services
Accounts payable services
Ageing report & summaries
Payroll processing
Bank account reconciliation
Financial statements preparation
Trial balance
Income statement ( Profit/ & Loss )
Balance sheet
Cash flow statement
Audit



Demographics & Charge entry
Our trained Medical Billing Professionals will enter personal information about the patient from the
demographic sheet.
The team will then check the relationship of the Diagnosis code with the CPT.
A change will then be created according to the billing rules pertaining to specific carriers and locations.
All charges will be accomplished within the turnaround time agreed with the client, which is generally 24
hours.

Audit
The daily charge entry will audited to check the accuracy of the entry based on carrier requirements to
ascertain a clean claim.

Coding
Our Medical Coding service enables individuals and Hospitals to file a claim with the patient's
health insurance provider, managed care organization, or government entities.

Our These codes help medical insurance and others to understand what was wrong with
the patient, whether treatment was necessary and what services were administered.

All these codes help non-medical staff at the insurance company and other health service providers to
handle the claims and make payments on a predetermined basis. Our specialty is ICD-9, CPT, HCPCS
outpatient (physician) coding for the CMS-1500 /2000 form.



Claims transmission
Claims will be filed and relevant information sent to the Transmission department.
The operations team will then prepare a list of claims that are transmitted electronically. Once the claims are
transmitted electronically, confirmation reports will be obtained and filed after verification.
Paper claim will then be printed along with attachments and dispatched to insurance agencies.
Finally, transmission rejections will be analyzed and appropriate corrective action will be taken.

Cash posting
The cash posting team will receive the copy of check and EOB.
The team will then apply the payments in the billing software against appropriate patient account.
During cash application, overpayments are immediately identified and refund requests are generated.
The analysts will then be informed of underpayments and denials.

Analysis
Account receivable analysts will research the claims for completeness and accuracy. The AR analysts will
then set orders about making calls from the call center.
The analysts will also research denied claims, rejections received from clearing houses and low payments
by carriers. After this research is completed appropriate action will be taken.

Calling
The call center executive will call the insurance agency and verify current status of the claim (whether it is
being processed for payment or is being denied).
Based on the claim status, the analyst will get the pre-requisites needed. If the claim is being processed for
payment, a list of payment details will be compiled. If denied, corrective action will be initiated.



The Call Center Team will receive work orders from the analysts. The Call Center Executive will then initiate
calls to the insurance companies to establish reasons for the non-payment of the claims. All such reasons
will be passed on to the Analysts for resolution.

Month End Reports
At the end of the month, Phoenix & York will run procedure code usage reports and aged summary reports
to asses what has been achieved for that particular month, and also to identify patterns of non payment if
any.
If any claim is found to be older than 60 days, immediate action will be taken. Any claims pending for
clarification will be passed on to the respective account manager for remedial action.

Insurance eligibility verification
Patient Eligibility check is made online through Insurance websites to check benefits, Effective date of Policy
etc.
We also have a specialist Team that verifies Benefits by calling the Insurance companies
This process would ensure cleaner claims being submitted to the appropriate Insurance companies.



Specialties
Phoenix & York professional team, which is innately capable to ramp up in short notices, possesses a wide
variety of skills and can perform variety of roles.

Phoenix & York has experience in the following specialties.

Family practice
General practice
Gynecology
Internal medicine
Neurology
Nephrology
Obstetrics
Psychiatry
Pulmonary diseases
Radiology
General surgery
Physical therapist
Pediatric
Pain management



Account Receivables
Phoenix & York can help in following up pending claims, initiating collections, tracing the reasons for
claims denials, tracking outstanding receivable balances by customer and by the date when payment is due,
providing periodic reports and more.

The claims get denied mainly due to:
Duplicate claim
Additional information needed to process the claim
Incorrect or missing CPT procedure code
Physician’s name and/or UPIN missing or incorrect
Incorrect or missing place of service code

Phoenix & York can
Reduce average days in accounts receivable
Reduce write-offs from bad debt
Reduce claim denials
Improve your cash flow
Increase your revenue by up to 40%
Improve customer service and patient relations


Insurance Forms Process

Phoenix & York offers end-to-end healthcare insurance administrative services. Phoenix & York provides
Health Insurance Forms Processing services, from HCFA /CMS 1500, UB 92 and Dental forms in different
formats.

Our Services include:

Mail processing services preparatory to scanning
Document scanning
Offshore Data entry with high quality output
Archival & Storage

Phoenix & York ensures 99% accuracy in data conversion to prevent payment errors down the line.


Insurance Forms Process - Diagram

FTP
Serv
er
Download folders
Insuranc Convert into
containing Scanned
e Forms Electronic Format Images
from
the
Client Scanning
Local
Serve
r

Distribute
image to the
Pro Asst

Capture the
required fields

QC


Document management

Document Management (Onshore):

Phoenix & York can provide a range of services to manage the handling, sorting and preparing of paper, microfilm
and microfiche prior to image conversion. The range of imaging services includes:

• Image capture
• Indexing
• Optical storage
• In-house or remote access and viewing
• Multi-site and multi-user access and viewing
• Image processing
• Image retrieval
• Interface to workflow or in-house systems
• Provision of in-house managed services
• Provision of document imaging systems.


Data management

Data Management Services

Capture and enhance

The data capture services of Phoenix & York brings international resources and over several years of experience
in the digitizing, processing and management of data. The company employees highly skilled specialists providing
an aggregate capacity of over one billion key depressions per day. The services include:

• Project specification
• Document receipt and preparation
• Manual editing and coding
• Key from paper, microfilm, microfiche and image
• Optical Marks Reading (OMR)
• Optical Character Recognition (OCR)
• Image Character Recognition (ICR)
• Data output (to tape, disk, CD, mainframe or on-line)

Database Management

Capturing data to specific instructions alone does not always provide the end customer with the desired result to
complete the process. Phoenix & York provides a range of Data Cleansing and Data Querying services to process
keyed data. This service includes:

• Offline validation of keyed information using external tables
• Application processing with data irrigation and intelligent transcription
• Database construction and migration using human intelligence
• Database management


Accounting/Financial services

Account/Financial/Bookkeeping Services
Phoenix & York is a preferred supplier to many large financial services organizations providing value added
services in supporting its back office operations. The company has made significant investment in people, process
and technology to provide its customers with a suite of services in HR processing and back office accounting
services. The company has a proven track record in handling:

We have a very user friendly process in place. You can send your paper documents through an e-fax or by
scanning & emailing it. Once we receive the scanned image of the document, it is filed in a document
management system & the transaction is posted in the accounting software of your choice .

We can update your books with in 24 hours Turn around time. This can be carried out by using QuickBooks back
up. We upload the updated books on to a secure server.

There are three options for using the Accounting package.

• Using an ASP version.
• We can host a server in our centre or a web form, with restricted access.
• We could log in to your server & post the entries.


Accounting/Financial services

Bookkeeping Services Includes

Computerized processing of all checks and bookkeeping information.
Bank statement reconciliation.
Preparation and review of monthly financial statements.
Maintenance of employee and sub-contractor earnings records.
Preparation of all payroll related tax returns.
Preparation of year-end W-2 and 1099 forms.
Day-to-day bookkeeping and accounting.
Books balanced and reconciled quarterly.
Management accounts produced quarterly.
VAT returns produced quarterly.
Annual accounts and tax returns preparation.
Submission to Inland Revenue.
Submitted to Companies House.
Expert tax advice to minimize tax liability.
Adjustments to year-end accounts.
Storage of documents at our offices


Advantage

Phoenix & York Guaranteed

• Measurable benefits
• Cost savings
• Guaranteed quality
• Faster closure
• Focus to grow the business
• Better books, better profits
• Security of your data
• 100% accuracy of your data
• 24/7 communication


Infrastructure Management

Network Server
OS & Applications Remote Desktop Mgmt
Management Management

Cisco Compliant Domain, Ftp, Production with
Windows XP, Windows Vista, Daily Event Log,
Routers, Leased Links, Server Rack, Windows 2003
MS Office & Image tool Patch Mgmt, Policy admin
LAN & Firewall Server Environment

Managed Security Services - Firewalls, IDS, Anti-Virus, Virus Scanning, Network Scan for Security etc

Physical Security – Bio Metric Scan ID for All Employees, 24/7 Physical Security Service, Bio Metric Scan ID for All Server
Rooms, CCTV, Fire Protection, E-Centrex Communication System for All Employees, Disaster Recovery offsite Center


Contact Details

Global Delivery Centre
Ispahani Center, 123/124, Nungambakkam High road,
Chennai – 600034
Tel – 91 44 66141602/ 91 9940676954/ Fax: 91 44 66141602

Raja ruban ( Head of IT enabled Services
Ruban.t@phoenixyork.com
Web: www.phoenixyork.com


Phoenix & York Ites Presentation

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