With our 2, 000+ coders, youll have one of the largest and most experienced medical coding services company on your team. Our FlexSource solution provides you with a customized solution for your needs. You get to pick the delivery location that meets your specific scope, preference and budget. Whether you need coders onshore or offshore or in both locations the choice is yours. In addition to that you get access to our technology and best practices as part of the solution.

Technology: GeBBS coders use your technology or our proprietary iCode Workflow coding software, which enables faster and more accurate coding. In addition, coding quality is monitored and improved using our proprietary iCode Assurance coding audit software.

Find out how FlexSource can benefit your organization.

Hospitals and healthcare providers are faced with profound challenges while trying to achieve revenue goals without jeopardizing quality and regulatory compliance. Having a commitment to coding quality is key to having a successful revenue cycle, and its all being tested by the RAC, the MAC, and ICD-10. How can you be sure that youre not at compliance risk? Are you leaving revenue on the table? Coding compliance audits can help you answer those questions.

A GeBBS coding and documentation compliance audit is comprehensive and relevant. We employ a proprietary and proven methodology that is designed to assess your coding accurately and offer you the opportunity to reach the operational excellence for which you are striving. After the coding compliance audits are completed, we will provide you with a detailed and customized report outlining our findings on how you can improve your coding accuracy, your clinical documentation, and your reimbursement levels. Our approach assists you with meeting CMS, AMA, AHIMA, and AHA standards.

Our auditors are professionals of the highest caliber and may use our propriety iCode Assurance technology, a customizable coding audit solution for your medical coding audits. They are credentialed, experienced and passionate about getting even the smallest details right. We have worked with hundreds of hospitals, physician groups, and other healthcare companies to help them find inefficiencies, eliminate errors, and follow best practices.

Medical record documentation is vital to a strong revenue cycle and is crucial to patient care. Regulatory requirements and payer guidelines are focused on the medical record, making accurate clinical documentation more important than ever. Healthcare organizations have been challenged by regulatory changes, Recovery Audit Contractors (RAC), medical necessity requirements and the transition from volume to value, which has impacted their ability to be reimbursed. The increase in denials across the industry bears witness to the fact that a robust Clinical Documentation Improvement (CDI) Program is necessary to a successful revenue cycle.

Clinical Documentation Improvement (CDI) Programs provide value beyond direct revenue. GeBBS offers a well-established CDI program that enables healthcare organizations to improve communication among healthcare providers, portray accurate physician quality profiles reflecting the true severity of their patients, and a culture of collaboration with the HIM Medical Coding team.

Our team of certified CDI experts will partner with your medical coding services team to maximize your reimbursement and receive accurate compensation for the services you provide. Whether youre seeking an assessment of an existing CDI program or a partner to supplement your current staffing model, we have a solution for you! Offering interim and permanent services, were here to help you develop, improve and maintain your clinical documentation.

GeBBS Healthcare Solutions, Inc. (GeBBS) is pleased to provide this evaluation and management (E/M) leveling calculator for professional services to the broad HIM and coding community. The calculator is not intended as a replacement for the official coding guidelines published by the Centers for Medicare & Medicaid Services (CMS) or any guidance provided by local fiscal intermediaries. Users of the calculator understand that the suggested E/M code is based on user inputs and should rely on official guidance provided by CMS, references provided by the American Medical Association (AMA) as well as other official sources to make a final determination. GeBBS does not provide any warranty or guarantee of any kind.

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Are you having trouble keeping your Accounts Receivable (A/R) days under control? Is a lack of skilled resources leading to a backlog of claims that need to be processed? With ICD-10, the potential for the number of denials is certain to go up if you are not prepared. It is critical to success to have access to a large pool of qualified resources that work in any Practice Management System and understand how to quickly and correctly analyze account history, appeal denied claims, and get timely turnaround to recover on and close out A/R. Analysts who trend denials and look for patterns of deficiency will increase cash flow and reduce aging A/R.

GeBBS A/R Solutions can lower internal costs, increase collections, and improve your cash flow. We specialize in enhancing the financial performance of our clients by seamlessly supporting Revenue Cycle Management (RCM) and related processes. As a partner to our clients, GeBBS serves as a direct RCM extension to Hospitals and Physician Practices by leveraging healthcare expertise, technology and qualified resources.

GeBBS provides access to a scalable and large pool of resources experienced in multiple Practice Management Systems to increase your collections ratio. Our sophisticated A/R workflow tool seamlessly performs skill-based routing. It also generates customized intelligent reports that help quickly identify and resolve unpaid accounts. Our skilled staff is trained to identify patient accounts that require follow-up and take the necessary action to collect unpaid/underpaid claims.

GeBBS provides end-to-end, comprehensive Revenue Cycle Management solutions from payor credentialing to complete billing and collections services. With 12+ years of RCM experience, our billing experts are well versed in all Medicaid state plans, managed care plans, government-funded programs, third-party insurance, and Medicare billing rules. We follow industry-standard key performance metrics to measure success and integrate best practices, so that you get the value of our proven experience and expertise.

The Solution includes:

PMS/EMR System and RCM Process Implementation
Scheduling, Eligibility Verification, and Pre-Authorization
Medical Coding
Claims Submission (Use your clearinghouse or a partner of ours)
Accounts Receivable (A/R) Management
Credit Balance Resolution
Customer/Patient Access Solutions

HFMA calls credit balances the stealth aircraft of hospital patient accounting. This is because the credit balance is a liability that is hidden within the accounts receivable ledger. This liability carries with it real and serious financial and compliance risk. It is your fiduciary responsibility to manage these real risks. Industry data shows that over 55% of credit balances are a result of incorrect posting of allowances.

Federal Register published rules that went into effect in mid-March 2016 that:

Providers must repay Medicare overpayments within 60 days of identifying the overpayment, although they can take up to six months to investigate suspected overpayments.

Providers must repay identified overpayments occurring within the past six years.

Repayments can be made by refunds, claims adjustments, a credit balance, or another appropriate process.

Penalties are stiff for noncompliance. Providers that do not report and repay the overpayments are subject to penalties under the False Claims Act and could be prohibited from participating in federal healthcare programs, according to CMS.

GeBBS has built strong working relationships with our clients to consistently meet their needs as credit balance backlogs are prioritized and processed. Incorrect adjustments, erroneous credits, and misuse of debit codes makes this credit balance task quite challenging, requiring precision, attention to detail, and a focus on operational excellence.

The healthcare environment is changing. The Affordable Care Act and the transition to ICD-10 put an added layer of expense and complexity on our already burdened system. Patient volumes are on the rise with the newly insured, and high-deductible plans are putting added pressure on revenue cycle operations and their drive to collect. The key to success is access to a large pool of qualified denial management resources that work in any Practice Management System and understand how to quickly and correctly analyze account history, appeal denied claims, and get timely turnaround to recover on and close out A/R. Analysts adept at trending denials and looking for patterns of deficiency will increase cash flow and reduce aging A/R.

GeBBS provides the access to a large and scalable pool of resources experienced in multiple Practice Management Systems.

The most important factor in the success of a practice is patient flow. An office that can successfully smooth out the spikes in its schedule can see more patients more efficiently, which reduces wear and tear on office staff and physicians. Efficient patient scheduling is key to improved patient experience prior to and after the visit.

The GeBBS Patient Scheduling Service analyzes the peaks and valleys of patient flow and seasonality to manage the schedules. Capturing critical patient information while providing exceptional patient experience on call has helped our physicians reduce the overall wait time for the patients and reduce the time for new patient registration/enrollment.

The scheduling service offers exceptionally talented staff, with flexible staffing schedules to manage call flow for appointments. The seasonality factor is built into the staffing plan to ensure that we are not turning away any patients. The staffing schedule is planned in line with the seasonality and can ramp up at short notices to manage the patient flow for a superior patient experience.

Successfully managing patient flow takes thought and careful planning. It is by far one of the most challenging aspects of practice management. But when done correctly, smoothing the patient schedule will increase the capacity and efficiency of your practice without increasing your overhead.

With the Affordable Care Act, insurance and eligibility verification is absolutely critical. Identifying patient responsibility upfront prior to the visit is critical to managing the receivables. In the absence of proper eligibility and benefit verification, countless downstream problems are created delayed payments, reworks, decreased patient satisfaction, increased errors, and nonpayment.

A 2009 McKinsey Quarterly survey of retail healthcare consumers showed that 52 percent of consumers would pay from $200 to $500 or more by credit or debit card when they visit a physician, if an estimate was provided at the point of care.

To avoid these problems, GeBBS provides a remotely-hosted Centralized Eligibility Unit for hospitals, faculty practice plans, PMS/EMR vendors, and billing companies. The solution consists of GeBBS staff, technology, management and expertise that delivers high-quality, cost-effective patient insurance eligibility and related services.

GeBBS Eligibility Verification Services has the potential to:
Improve A/R cycles (reduce A/R days)
Increase cash collections by reducing write-offs and denials

Eligibility and Benefits Verification
Receive schedules from the hospital via EDI, email or fax
Verify coverage on all primary and secondary (if applicable) payers by utilizing sites like WebMD, payer web sites, interactive voice response systems, and phone calls to payers
Contact patients to get updated insurance information
Provide the clients with the results, which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information, and much more

Other Optional -Related Services
Obtain pre-authorization number
Obtain referral from PCP
Enter/update patient demographics
Remind patient of POS collection requirements
Inform client if there is an issue with coverage or authorization
Process Medicaid enrollment

GeBBS leverages technology and workforce management to reduce abandonment rates and increase first-call resolution. Whether were processing a payment, scheduling appointments, or addressing a balance inquiry, our call center representatives provide a customer-focused approach leaving patients feeling respected. The GeBBS state-of-the-art patient call center in Manila, Philippines handles healthcare inquiries exclusively. It offers the up-to-date infrastructure needed to handle heavy call traffic and manage call volume peaks and valleys with ease. Experienced healthcare billing staff provides quick resolution to patient issues and queries.

Highlights of the Patient Call Center solution include:

Detailed study of the clients call patterns, conducted by GeBBS transition managers, including a reason for call analysis to identify automation opportunities
Implementation of an interactive voice response (IVR) to handle simple queries such as balance inquiry and statement requests
Implementation of a patient portal to automate credit card payments
Flex-staffing to manage peaks and valleys in call volumes
Staffing analysis using Erlang-C model
Extended operating hours to manage all U.S. time zones with live operators and an after-hours voice mail system
Implementation of a real-time call management and reporting solution

A 2009 McKinsey study found that 74 percent of insured consumers indicated that they are both able and willing to pay their out-of-pocket medical expenses up to $1, 000 per year and 90 percent would pay for medical expenses up to $500 per year.

Reasons for a rise in self-pay bad debts are due in part to inefficient and ineffective collection practices followed by billing companies and physician practices. Providing the patient with easy access to patient statements that are easy to understand will help drive higher patient collections.

The GeBBS self-pay collections team uses technology-enabled practices to maximize patient contact.
Automated dialers
Digital messaging campaigns
Mobile technology to drive text messaging campaigns

The Self-Pay Collections team leverages analytics to arrive at the best time to contact and propensity to pay scores to create outbound campaigns that are patient experience-oriented, non-obtrusive, and drive higher patient connect ratios.

We work with the patients and offer them flexible payment options and easy access to payment capabilities via web, phone, credit card, and e-check payments.

Merit-based Incentive Payments System (MIPS) Solutions

As the U.S. healthcare system transitions to value-based reimbursement, providers face both opportunity and risk in their arrangement with payers. Value-based reimbursement is demanding that providers meet certain quality thresholds, to be optimally reimbursed. To survive and thrive in this new environment, it is critical that healthcare organizations partner with a company that has the proven competence to help them transition from fee-for-service to value-based care through the use of experienced people, technology and proprietary tools. GeBBS has over 300 certified coders supporting our clients on MIPS initiatives.

GeBBS MIPS Solutions:

Identify and abstract applicable MIPS quality measures
Assess and analyze all documentation
Identify all applicable quality measures
Enter abstracted quality measure(s) data
Reporting through registry
Analytics and dashboards

GeBBS Payer Solutions improves government payers and risk-bearing providers management of contracts. Our payer solutions allow clients to improve their risk adjustment and quality programs by giving them a complete platform that gives them actionable data and solutions to act on them.

With the largest health plans and healthcare organizations as clients, GeBBS is well-respected for providing some of the highest results in the industry around risk adjustment coding (HCC coding), HEDIS abstraction and retrieval. This is accomplished with a technology-enabled platform, exceptional project management and focus around client satisfaction. We partner with our clients to emphasize transparency and trust and appreciate the opportunity to become a valuable extension of your team every step of the way.

Our proprietary technology platform provides flexibility to choose the services and platforms you need to be successful. We provide global resources and a variety of services, workflows and platforms all of which can be customized to your needs.

Getting the most out of risk adjustment programs requires the right technology and resources with an expert focus on risk adjustment. This comes with an in-depth evaluation and a 360 degree look at your data and initiatives. An outside look is often the most effective way to truly get it right. Whether youre a payer or a risk-bearing provider, we make sure you get the right RAF score and help you maximize the impact. Our risk adjustment platform provides an accurate, real-time look at your risk scores based on a comprehensive and ongoing review of your data. Our proven service delivery model takes chart review to the highest level, ensuring timeliness, quality, accurate documentation and optimal results.