Healthcare Sherpa is a Revenue Cycle Management service provider, which serve end to end RCM services to all Healthcare Providers throughout United States. In Healthcare Sherpa, Revenue Cycle Management Services includes but not limited to Medical Coding Insurance Verification Patient Demographics and Charge Posting Claim Submission (or) Transmission Payment Posting Denial Management Accounts Receivable Management Printing and Mailing Patient Statements We offer all these services as a Healthcare Sherpa’s complete suite or as a standalone services such as only Charge Entry or only Accounts Receivable(etc)… as per our providers (or) clients comfort zone.

1. Revenue Cycle Management Solutions
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2. Healthcare Sherpa’s Revenue Cycle Improvement System
REVENUE CYCLE IMPROVEMENT SYSTEM
PLANNING IMPLEMENTATION
Identify Benchmark Constant Implement
actual/ base Develop process Changes, Set Continually
potential performance Management improvement Productivity monitor
problems in to industry Reports to eliminate & Provide performance.
RCM cycle standards problem feedback
RESULT
Increased Practice / Fewer Rejections &
Enhanced Cash Flow Fewer Write-off’s
Provider Revenue Denials
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3. Sherpa’s Auto-regulating Process Flow to Increases Revenue,
Enhances Cash Flow and Reduces Write-Off’s
Proper input of patient
insurance info & codes
into the billing software
Cycle billing method for
Verify address /
patient statement and
three statements scenario insurance change at
for collections every encounter
Involve patients in the
process for faster Insurance Eligibility
payment & Verification
24 hrs TAT by
Timely follow-up & No
resubmissions without submitting claims
carrier calls on same day
Delay in submitting
claims at the year
beginning (to reduce no.
of deductibles 3

4. Scheduling and Patient Registration
99% accuracy with process for gathering
Problems complete patient demographic information
reduces 20% of rework
• Inaccurate / Incomplete
patient Demographic
Information
Sherpa’s Process-oriented Insurance and Eligibility
verification leads to faster payment within
• Inaccurate / Incomplete
Insurance information
Solution 20 days
• No verification of
financial information
Process based verification of patient ‘s plan
benefit, results in prompt 80% POS
collections
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5. Charge Posting
20% additional effort in charge entry
with random Q.C. reduces duplicate
charges & time spent chasing wrong AR by
5%
Problems
Process based posting and submission of
all services bring down TFL exceed denials
• Duplicate Charges by 99% and reduce revenue loss by 2-5%
• Un-posted Charges
• Wrong Insurance
Sherpa’s Process based insurance verification
keeps claim resubmissions ratio to
Selection Solution 2%
• Missing Authorizations
& Referrals Good knowledge of insurance id formats
and an extra minute spent to recheck
• Neglecting Payer insurance keeps claim rejections below 2%
Contracts
Separate process step reduces
authorization and referral denials to 5%
Process step for generating charge reports
and regular contract updates ensures
correct contract details and keeps contract
denials under 1% 5

6. Payment Posting
Facilitate EDI agreements with insurance
companies. Leverage electronic posting to
Problems track payments and to bring down AR
Balance to 15%
• Lack of reconciliation
• Patient statements Sherpa’s Ensure accurate analysis of EOB and bill
with wrong patient correct patient balance to avoid compliance
balances Solution issue
• Ignoring secondary
payment submission
Sherpa’s process for secondary re-submission
by printing or uploading the primary EOB’s
brings loss of revenue down from 10% to 2%
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7. Denial Management
Problems Denial analysis and prompt appealing
• Medical necessity
• Non-Covered Services
Sherpa’s
Process-oriented COB verification
• Co-ordination of benefits Solution
• Prior-Authorization /
Referral
Ensure claims submission to insurance with
auth/referral & Retro-auth appealing
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8. Insurance Follow-up
Improved workflow process and
increased productivity using our
Problems proprietary AR tracking spreadsheet to
prevent 30% loss in revenue.
• Lack of proper follow-up
• Pending claims never Prioritize work on Old AR and try
worked to collect >7% of old claims
• Erroneous claims that
Sherpa’s
are not resubmitted Solution
Improved claims appeal process prevents
• Ignoring Old AR up to 20% loss in revenue
• Ignoring claims appeal
Process-oriented insurance
• Ignoring insurance correspondence with necessary
actions (e.g., Medical Records, Primary
correspondence EOB etc.,) eliminates payment delay
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9. Self-pay Follow-up
Getting correct patient address from
USPS & verifying with TP software
Problems (e.g., White pages) to avoid sending
statement to incorrect address
• Incorrect data collection at
front desk
• Statement sent to wrong
address Sherpa’s Proper insurance eligibility verification along
with benefit plan to eliminate non-covered
• Rendering Solution service denials
Non-Covered services
• Inadequate patient
contact
Leveraging experienced patient account
representatives to lower Bad debt
adjustments from 20% down to under 5%
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10. Privacy Confidentiality & HIPAA Compliance
• Secured Premises- guarded 24*7
• All employees signed to a confidentiality agreement
• Restricted and monitored internet access
• No media drives
• HIPAA compliant Secured Data transmission
• HIPAA compliant products and procedures
• Frequent training and trouble-shooting per HIPAA guidelines
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