SERVICES / Medical Coding

Medical coding or medical classification is the transformation of healthcare diagnoses, procedures, medical services, and equipment into universally accepted alphanumeric codes, which are assigned from a code set i.e., ICD-9 CM, the International Classification of Diseases, Ninth Revision, Clinical Modification, which is most widely recognized medical classification maintained by the World Health Organization (WHO), the primary purpose being to categorize the diseases for morbidity and mortality reporting following certain rules of underlying classification and other coding guidelines.

The diagnoses and procedure codes are taken from medical records, such as transcribed notes of physicians, laboratory reports, and radiological findings, etc. Medical coding professionals ensure that the codes given are correct during the process of coding, which includes abstracting the information from the documentation, assigning standard codes for clinical statements using CPT, ICD-9-CM, and HCPCS Level II classification systems, and creating a claim to be paid by insurance carriers.

Coding is an invisible engine of the healthcare system. Without it, the entire healthcare industry would be unable to efficiently transmit important data, and healthcare providers would have an incredibly hard time getting paid for their services. In a nutshell, it is the medical coder’s job to translate the healthcare provider’s report of a patient encounter into numeric or alphanumeric code, which in turn is used by the medical biller to make a bill, or “claim,” for the insurance company and determine the appropriate charge for the patient.

Here where comes the pi-safe™ into picture, which provides a complete database of codes and reference library empowering the end users to make the right decisions. The transcribed reports, which are electronically searchable, enable pi-safe™ to recognize all the required procedures and diagnoses from the report and prompt the coder with the appropriate codes instantly, and make the process of reviewing much faster.

pi-safe™ being the product of pi international global solutions®, which in turn has a core and dedicated team of medical coders in-house who are certified by AHIMA (American Health Information Management Association) and AAPC (American Academy of Professional Coders) who offers state-of-the-art diagnostic and procedural coding across major medical specialties.

pi-safe™ performs Quality control (QC) checks to ensure that the performed service adheres to a defined set of quality criteria or meets the requirements of the client or customer, and also Quality assurance (QA) checks to ensure whether the quality during the process (from the beginning to the end of coding process) meets the specified requirements and also to calculate the percentage of errors at each level of data entry. If too many instances of errors or deviations occur in the quality then corrective action will be taken by giving training and educating the coders to improve the production and service process. Finally, the QC and QA process is maintained to ensure that remedial efforts have produced satisfactory results and to detect any recurrences or new instances of trouble.
Medical Billing

The medical billing process is an interaction between a health care provider and the insurance company. The entirety of this interaction is known as the billing cycle sometimes referred to as Revenue Cycle Management. This process of generating revenue involves managing claims, payment, and billing. Medical billers, plays a key role, who on the other hand process and follow-up on claims sent to the health insurance companies for reimbursement of the services rendered by a healthcare provider.

Like medical coding, medical billing is an invisible engine of the healthcare system without which the healthcare providers would have an incredibly hard time getting paid for their services. In a nutshell, it is the medical biller’s job is to review hospital and patient records, calculate charges, examine and submit claims, answer patient questions, and manage the payments and remittances.
The healthcare providers are contracted with the insurance companies to provide healthcare services.

Medical billing process begins when the provider sees the patient in the office, the patient’s medical report undergoes the process of coding where codes are assigned for the diagnoses and procedures, and these codes assist the insurance company in determining coverage and medical necessity of the services in the form of claims. The insurance company processes the claims for approval or failure. Failed claims are denied or rejected, which are returned to providers, who decipher the denial message, make required corrections and resubmit the claim. A denied claim is one that has been processed and the insurer has found it to be not payable and a rejected claim is one that has not been processed by the insurer due to a fatal error in the information provided, such as inaccurate personal information (e.g. name and mismatch in identification number or truncated procedure code, invalid diagnosis codes, etc.)

pi-safe™ intuitive and intelligent data review screens minimize the chance of error or missed data to negligible. Seamlessly handles the CMS-1500, CMS-1450 (UB) forms and allows to print paper insurance claims or to file electronic claims. Capability of transmitting claims electronically to vast number of carriers nationwide with criteria specific to each carrier. pi-safe™ ensures maximized reimbursement with follow-up on all delinquent claims, checking status, and ensuring processing with sophisticated Financial Ledger facility.

pi-safe™ allows one-click viewing of all the open claims for the same patient, and fast toggling between views of the patient's current balance, the insurance balance, or recent billing & statement data, and also keeps track of every penny to be paid. Provides a choice of multitude and unmatched management reports, including patient, procedure and payment day sheets; practice analysis; referring provider reports; referral source reports; patient and insurance aging reports; financial ledgers; and patient ledgers.

Medical Transcription

Medical transcription, also known as MT, is an allied health profession, which deals in the process of transcription or converting the recorded information dictated by physicians or other healthcare professionals into a hand-held cassette recorder or a regular telephone, into text format or edit reports that have gone through speech recognition software. Medical transcription renders and edits doctor dictated reports, procedures, and notes in an electronic format in order to create files representing the treatment history of patients.

Usually, hospital facilities prefer to have electronic storage of medical records due to the sheer volume of hospital patients and the accompanying paperwork, which allows them immediate access to subsequent departments or providers regarding the patient's care, notation of present or previous medications, notification of allergies, and to facilitate healthcare services to the patient regardless of geographical distance or location.

pi provides the facility to record the dictations by calling to the dedicated toll-free line from anywhere. We ourselves have a highly skilled and well-experienced team of transcriptionists in-house, who are bound to transcribe verbatim (exactly what is said), and relentlessly endeavor to maintain accuracy and security while converting the confidential patient information into text document.

pi-safe™ has integrated dynamic and customized templates with autocorrect and auto-expand abbreviation capabilities to have properly formatted, edited, and reviewed medical transcription documents. pi-safe™ allows to login to web account to access the transcribed reports and dictations to approve the reports. The transcribed reports created are electronic searchable data that enable the practice streamline to be the most efficient, and have an instant and ‘at a glance’ access to current and historical patient data with a click of a mouse. pi-safe™ automatically places a digital signature, date, and time once the report is approved by the Provider.

Scanning & Indexing

Scanning, or digital imaging, is a process whereby a document is converted from print to a digitized version of photocopy that can be viewed on computer or in a computer-readable format. Digital images produced by scanning are equivalent to photographs produced by digital cameras; they can be transmitted, displayed, and printed, but as images they are not text searchable. In order to make searchable electronic text, one must either transcribe records by typing or perform optical character recognition (OCR) processes upon digital images following scanning. Scanning, or digital imaging, is an increasingly popular strategy and can be a useful tool for dealing and managing the records and enhancing workflow. The main purpose of scanning is to get fast and quick access to the records, whenever it has to be accessed frequently, or from remote locations, or simultaneously by multiple users, scanning can be a cost effective means of distributing and rendering information.

Indexing is the process of entering information from historical records into an online, searchable database. Indexing improves searches for locating data quickly, and provides alternative ways to organize the information by reducing the search time whenever the database is accessed for both rapid random lookups and efficient access of records. Manual indexing assigns index database attributes to content by hand, typically used by the database of a "manage" component for administration and access. Both automatic and manual attribute indexing can be made easier and better with preset input-design profiles. Automatic classification programs can extract index, category, and transfer data autonomously.

Storage and retrieval of records are two of the costly functions an organization has to bear. Paper records not only take up valuable storage space, but also can be the most crippling to a business, if the records are destroyed by fire, stolen by disgruntled employees, misplaced or lost.

pi can support to convert the total life-cycle of the company’s paper document into electronic images and integrate into an EMR to enhance the workflow in on-site and off-site. By utilizing our intelligent software, state-of-the-art hardware, and our professional team, the benefits are fast, consistent, and accurate. With our high volume and high quality document scanners and data entry services, one can replace the cumbersome methods of document storage/retrieval and have instant access to the information. The digital images and index information are customized in formats as per the requirements and specifications of the clients. Above all, pi diligently practices high level of integrity, confidentiality, and security while dealing with the documents.