Business Process Services

Cost Savings. Revenue Enhancement.

Robust Processes. Flexible Processes.

Two sets of expectations that companies demand of their outsourced relationships. Quintessence has always been cognizant of higher degrees of expectations and the challenges our customers face. We designed our services and solutions with these two parameters and factored in a third as well – future challenges.

Quintessence is that partner to meet your twin goals

What can we do?

QBSS is more than a regular process delivery vendor. We created best in breed processes to control costs & designed results focused solution to deliver higher reimbursements. Many years of experience through several engagements across the healthcare continuum has blessed us with nuances that we use as levers to hone our service delivery.

A reflection of this is our engagement model – designed to provide motivation for continuous innovation, our fee structure is success driven and performance mated.

The value we bring to your business

Here is a composite value matrix of what our engagements are enjoying

Business Process Services
 


 

Revenue Cycle Management


Improving the financial parameters of your billing is our business. Be it hospital or physician revenue cycle, our multi shore service model, technologies and consultation approach help you reach your business goals faster and with a higher degree of certainty. We touch every aspect of revenue cycle. From scheduling to account closure, our services and technology along with our combined knowhow, accelerate cash flow and provide ruggedness to your business.

Our track record speaks for itself. We have shown long term improvement in reimbursement by 2-7% with reduced denial and AR days by between 8-37%.

 

Services

Quintessence has you covered with respect to Revenue cycle management from scheduling to account management. Our services are designed modularly so you can either take all or choose pieces that you need additional resources. No matter what your choice, we deliver a technology dipped solution that can fit your business.

We touch every aspect of revenue cycle. From scheduling to account closure, our services and technology along with our combined knowhow, accelerate cash flow and provide ruggedness to your business.

 

Boosters for your business

If that weren’t enough, we add boosters to turbo power your processes. Either in reducing costs, increasing productivity or extracting more dollars. Check these that can be strapped on to core processes.
 

Boosters for your business

Boosters for your business

Quick benefits or Deep dividends

Our understanding of the revenue cycle business helps us to seamlessly plan a smooth transition of processes, set baseline, set benchmarks and embark on a mission to reach them. Our ability and adeptness to apply technology around your existing systems will reduce effort and rework. The transition process can be set to your level of comfort and flexibility so you can see immediate benefits with rapid scaling or a measured approach for deep dividends at every step.

Quintessence brings a front end focus to what is essentially a back office business. As a true partner, we mimic your business processes for a while. We then apply our learning and knowhow to build edits at every stage of the claim generating process. We do this without affecting your practice management system or your business processes. By paying attention to the source of data and ensuring tighter edits at that stage, we have shown increase in first pass rate by 2-6% with a corresponding positive impact on collections and outstanding days. Coding edits and audits slash another 20% of your denials.

 

The have the cake and eat it too options

Depending on your strategic and tactical needs, Quintessence works on your entire revenue cycle or on individual processes. Either way, your benefits are assured.

Contingency Fee model:-

Working on an end to end model, Quintessence brings substantial savings to your costs of collections, all the while increasing reimbursements. The combined impact will be such that your billing fee will almost become nil.

Cafeteria style Smart Sourcing
Depending on your selection of processes that needs external sourcing, Quintessence can demonstrate process level benefits. Each and every process will have metrics and service level agreements defined and linked to reimbursement. Customers benefit from a highly measurable approach that will provide clear visibility to savings, quality and effectiveness of the outsourcing process.

Experience and Expertise combine – The Quintessence knowhow Matrix

We have you covered on your choice of billing system or your specialty or setting. If we have not worked on your unique process, we will invest to learn.

 

practice management
 


 

Coding and Auditing


We believe coding is the soul of the business of revenue cycle. It requires a high level of knowledge, application, industry awareness and experience to ensure compliance and best possible reimbursement.

“With one of the most experienced coding leadership in the industry, we can provide the highest quality coding services – both professional and facility. We put quality of our coding over quantity of charts coded and hence our coders consistently deliver better than industry benchmarks. All our coders have masters or bachelors academic qualifications in the areas of medicine, life sciences and microbiology.

Quintessence can fill in for your vacations, working backlogs, deducing your coding denials, or manage your entire coding operations.

How we work?

We have established HIPAA compliant secure VPN access to our clients’ EHR or medical record repository to access and code directly on to HIM or billing systems.

We deploy experienced and certified coders (AHIMA Or AAPC) in your specialty.

Our coders are trained to on documentation deficiency reporting and compliance auditing.

We will turn around your charts within 12 to 24 hours so they are well on their way to appropriate payment before your day end.

Human – Tech Interface to coding

We had to use technology to improve efficiencies and accuracy in coding but all the while understanding that coding belongs to coders. So, Quintessence created a hybrid model to assisted coding that has a coder-technology interface like no other. This unique twin barreled approach that gives you the assurance of a certified coder and a top technology combined. Read More

ICD 10

If ICD10 worries you, Quintessence is the answer. A revenue and cost neutral approach to the inevitable transition helped create a revolutionary approach to tackle the biggest perceived challenge to the healthcare business.

Our coding and software experts put together a tool that aids coders to code in ICD10 through a series of choices leading them from an ICD 9 code to the appropriate one in ICD 10. This breakthrough approach has several advantages

ICD 10
 

Our process had been tested across thousands of charts across specialties and settings and has been validated to produce higher level of accuracy than coders trained on ICD10. Ask us for a detailed discussion and a sample case demonstration.

You also have the option of choosing the standard process mandated by industry to make the transition doubly smooth. Our coders are guided with the most current ICD-10 code sets. We deployed recommended templates for impact analysis and translation of all technology systems. All our internal coding systems have been reprogrammed to accommodate the new code set and are ready for implementation.

Fundamental to the ICD-10 transition effort is the education and training plan for coding staff. Quintessence has AHIMA-Approved ICD-10-CM/PCS trainers on staff, who have painstakingly put together comprehensive training materials. Thereby, all coders will complete the necessary proficiency exam (AAPC) or CEU’s (AHIMA) to maintain coding credentials with their respective professional societies.

We have started offering our expertise to help our customers also experience a smooth transition. We completed documentation sufficiency audit on 28 practices and provided detailed reports on areas of improvement.

Quintessence is ready for ICD 10. We can help you to get ready too.

 


 

Claims Processing and DRG Pricing


From Managed care companies, MA plans, Commercial insurance to HMOs, the leadership at QBSS has more than 100 years of experience as a team in configuring, implementing and managing smart sourced business processes healthcare payers than any.

We design highly cost-effective solutions that utilize clever technologies. Such a combination delivers enhanced proce5ss efficiency, financial and administrative accuracy of well above 99% and 96% respectively.

QBSS solutions are delivered using proven best practices that have a higher “dollar return on outsourcing decision” with considerably lower risks.

 

ICD 10

 

 

Risk amelioration and cost avoidance

We help health plans reduce and avoid erroneous reimbursements. It is a 3 step process involving a review of the medical records and validating the DRG, applying and RAC like edits and appropriate application of the DRG pricer.

We perform both retro and prospective audits and identify services that are incorrectly billed or inappropriately coded. We even cross check the DRG pricing to ensure there is limited opportunity for fraudulent billing.

 


 

HCC Coding (Retrospective or prospective Chart reviews)


Having managed the largest outsourced transformational engagemnet in this process, the leadership at Quintessence is the best bet to manage your RAPS program too.

Experienced Medical Professionals, Clinicians, Certified Coders, and an unassailable leadership in this area combine to provide quality Medical Chart Audit Services with huge cost savings that increase the effectiveness of your Risk Adjustment Programs.