Long Term Care BPO Services

1

Promantra Corporate Overview

Promantra – An ISO 9001 & 27001 Certified Organization | www.promantra.us | [email protected]

2

Promantra Overview

Established in August 2003

Head quartered in New Jersey with an offshore deliver center at Hyderabad, India

End-to-End Revenue Cycle Management / Long Term Care BPO Services / IT Services

Multiple clients across specialties

Customers across USA

HIPAA Compliant, ISO 27001:2005 & ISO 9001 Certified Organization

State-of-the-Art Technology and Infrastructure

Proven Vertical & Lateral Scalable Model



3

Industry Recognitions

Profiled-in Description

Global Services Media (Global Top 100)

Emerging Leader Award

Featured in the top 100 BPOs for three consecutive years

NASSCOM Showcase of Innovation Book

Outsourcing Excellence Awards Enlisted as a finalist

1st Healthcare BPO in Hyderabad (India) to be:

BS 7799 certified

ISO 27001:2005 Certified

Appreciated by PwC, KPMG and other external consultants for the Integrated Management System built on ISO 27001:2000 & ISO 9001:2005



4

Business Framework and Quality Deployment

Integrated Management System to meet all requirements of ISO 9001 & ISO 27001

ISO 9001 certified for qualitySix Sigma approach for all quality and process improvementsDefect prevention and quality assuranceTwo levels for quality check for all client engagementsISO 27001 for Information SecurityRegular grooming sessions based on quality feedback and client feedbackUpdates trainingBusiness Intelligence reportingProcess re-engineering and process improvements

Process Management Framework & Quality



5

HIPAA Compliance

Promantra ensures that our HIPAA Compliance policy:

Outlines handling and protecting confidential information (NDA signed)

Engages employees in securing Promantra’s critical systems

Explains the importance of security policies while conducting business

As a matter of practice, Promantra signs a Business Associate Agreement with all clients before exchange of any data



6

Long Term CareBPO Services


Long Term Care BPO Services

7Promantra – An ISO 9001 & 27001 Certified Organization | www.promantra.us | [email protected]


LTC AR & Billing Services

Objective:

To collect maximum revenues from current billing with accurate admissions, census tracking, charge posting and billing and to reduce aging buckets by denial management and claims follow-up audits for all the facilities mentioned in the Scope.

S No Activities Description

1. Admission & Discharge

processing

1. The process of entering Financial & Non-Financials information of the Resident’s accurately & timely into the system as soon as he/she is admitted into the facility2. Processing of discharge from facility or pay source changes in the system.

2. Census Building Census building is the process of tracking the residents’ attendance in the facility for the number of eligible days to be billed.

3. Charge Posting Charge posting is the process of entering the charges for the services provided to the resident during his stay in the facility.

4. Billing Billing is the process of sending out the claims to various insurance companies that provide health care insurance to the residents.

5. Cash Posting Cash posting is the process of posting the amount received from the resident as well as the various entities that might cover the residents health care cost.

6. Trust Posting Trust posting is the process of maintaining an account in a bank on behalf of the residents to ensure maximum benefits to their personal money.

7. Month End Closing The total financial activities are closed for a particular month so no other transaction can be posted or deleted.

Sub Processes handled:



Accounts Payable Services

Objective:

To effectively and efficiently identify, capture, and pay liabilities of the organization (Organization being Client). And to avail the discounts offered for early payments and avoid penalties for late payments.

Sub Processes handled:


1. Invoice ProcessingReceiving inputs on various types of invoices (resident refund, monthly leases, utility invoices, payroll tax invoices etc,) and processing into Geropro

2. Check Cut ProcessingBased on inputs from corporate office, check cutting is carried out and check print reports sent to the client

3. Invoice VoidingInvoice voiding is carried out in case of wrongly typed invoice date, invoice number, invoice amount, vendor name.

4. Checks VoidingCheck voiding carried out in cases of checks no. being wrongly typed; check to wrong vendors, wrong invoices, checks period validity expired.

5. Weekly Reports Weekly reports generated and sent on every Friday to Facility administrator, BOM, Corporate office

6. Month-End-ClosingAP module closed for all the facilities in Geropro as per identified schedule and generation of various Month-end reports



Payroll Services

Objective

To deliver accurate and timely pay checks to all employees of our client.

Sub Processes handled


1. Processing PAR (Personal Action Request) Receiving PARs for New hires and processing them into the Payroll module of GeroPro

2. Processing W4’s Receiving W4 forms along with new hire PAR to update the tax status of the employees.

3. Benefits Calculation (Vacation, PTO, Bereavement & Sick Requests approving)

4. Processing Term Checks Receiving inputs for Termination check processing and needs to process the same immediately.

5. Processing Payrolls. Receiving all payroll inputs and processing them in GeroPro every fortnight.

6. Maintenance of Garnishments



General Ledger Services

Objective

1. To generate and consolidate reports in terms of revenue and gains, liabilities, equity, (financial) for corporate and management team.

2. Financial reporting related to

• Recognition of assets, liabilities, equity, revenue and gains, expenses and losses and other Comprehensive income – for example, if and when to report a liability

• Measurement - for example, historical cost, fair value, or lower of cost or market and • Measurement methodology used• Presentation - for example, balance sheet display• Disclosure - for example, notes to financial statements

Sub Processes handled

S No Activities

1. A/P Closing

2. Payroll Accrual

3. Standard Journal Entries Posting

4. Auto Reversing Journal Entries

5. Additional Journal Entries (like, re-class JE’s, amortization, inter company transfers depreciation)

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Long Term CareSoftware - GeroPro



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Rising Costs Reduced Profits Shortage of Nursing Staff Complex Regulations

Pro

fits$

$$$

Challenges in Skilled Nursing Facilities



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LTC Software - GeroPro

Accounts Payable

Accounts Receivable

Payroll

General Ledger

Billing

Claims Manager

Resident Trust

PayPro

Vendor maintenance, invoicing and timely payments

Manage revenue cycle, census, aging and reimbursements

Features and functions to maintain employee records and payroll

Consolidated financial statements, book keeping and analytical reports

Provides ANSI 837 / 835 electronic billing to speed up revenue cycle

Claims scrubbing, electronic 837 and claims submission

In house resident banking system which tracks resident trust funds.

Employee access to their pay stubs, tax deductions, W2s etc...

GeroPro Financial Modules



Admission | Discharge | Transfer

MDS 3.0

Physician Orders

Medical Administration Records

MRD

24 Hour Incident Reporting

Clinical Document Manager

Nurse Tracker

Resident geographical information, Admission, Discharge & Transfer info

Assess the patient MDS Assessments as per state/federal specifications.

Resident diagnosis, allergies, dietary orders, Routine & PRN Medications

Capture resident's ADL, Vitals, Dose Tracker, Dietary, Nursing, & Therapy

Complete resident assessment and maintenance of Medical Records

Track incidents, avoid incident risks and step to follow

Digitize and maintain all old records & documents in electronic formats

Ensure compliance around nurses performance & monitoring resident care

GeroPro Clinical Modules



Dashboards

Compliance Manager

HRPro

CarePro

Admin

Support

Consolidated and granular view of facility operations

Conduct mock surveys and ensure survey readiness at all times

Facility employee document management system for HR team

Maintain records of Care Givers schedule, Care log on a timely basis.

User set up, access restrictions, user logs and activity reports

24/7 support from GeroPro experts on technical and customization issues

GeroPro Management Modules

Though GeroPro currently provides standard modules for Financial, Clinical and Management functions, we can also customize a particular module as per client’s need.

GeroPro has an in-house software development team that coordinate with the client to understand client specifications for customization during initial set-up and also as & when required as per the need.

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Before GeroPro



Typical LTC scenario: Clients using multiple software/Vendors for their day to day operations decrease in Top and Bottom Line due to duplication of efforts and

additional resources

LTC CLIENTMultiple software/Vendors

Clinical Software Admission Discharge Transfer ; MDS & Medical records

Account receivable software

Accounts Payable Software

Payroll Software

General ledger Software

Delay in updating resident informationDelay in MDS assessment

Only 65% --70% of the services provided will be billedAging increaseDenialsDelay in payments

AP Vendor management Issues

Payroll Issues Employee dissatisfaction

Loss of revenue /No Profit

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Promantra One Stop Solution



Accounts Receivables

& Billing

Accounts Payable

Experienced Accountants /

Medicos

General Ledger

Clinical Compliance /

Documentation

Clinical Decision Support Systems

Regulatory Requirements

Admit / Discharge ProcessCharges / Cash Posting

Billing / Month End Closing

Invoice / Check ProcessingWeekly Reports

Month End Closing

Benefits CalculationGarnishments

PAR / W4s / Payroll

AP Closing / Payroll AccrualAssets / Liabilities / Revenues

Balance Sheet

Proprietary Platform

GEROPROPayroll Processing

One Stop Solution - GeroPro

WWW.GEROPRO.NET

GeroProEHR

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After GeroPro



GeroPro software implementation results inIncrease the client’s Top and Bottom Line.

LTC ClientPost GeroPro

Implementation

GeroPro Result

99% + billing

Aging decreased

Less Denials

More collection

Employee satisfaction

Resident satisfaction

Accurate Payroll

Accurate vendor

management

More Profits

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Case Study-1

Case Study: Revenue Cycle and Finance & Accounting

Direct Benefits to one of our Clients since our engagement begun

Increased revenue (collections) of California facilities from $2.94 Million to

$3.52 Million in a span of one year

Increased Collection efficiency of each facility from 82-88% to 99% for

current billing (within 90 days)

Reduced Overtime wages by $23k Per Pay Period

Employment cost reduce by 47.6%

Cost Benefit of approximately $875K per annum.

Indirect saving of approximately $175K (20%) per annum.

Services OfferedBilling & Collections

Finance & Accounting

Client Description: 9 Skilled Nursing Facilities Group in Idaho & California with annual gross billing of $70 Million

Increased (99%) Collections Efficiency & Reduction in operating costs

Challenge: Collections efficiency impacting top line and bottom line

Case Study


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Case Study-2

Case Study: Denial Management & Revenue RecoveryClient Description: Client is a Hospital and Health Services center with 278 licensed beds and provides a full Complement of inpatient, outpatient, diagnostic and rehabilitative services for patients of all ages.

Challenge: Increasing back-log of Denied/ Rejected Claims, slow turn-around time on managing Denials internally

Promantra Solution

Quick and effective turn around on denials, rejections and collections

Streamlined the Denial Management process to eliminate revenue cycle

process break down

Dedicated team assigned to ensure every claim is followed-upon to identify

opportunities for revenue recovery

Reduced the denial bucket from $22M to less than $7.5M over a span of 12

months

Analyze the rejection back-log giving immediate and accurate visibility into

improvement opportunities

Services OfferedDenial Management & Revenue Recovery

Services

Case Study



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3

4

5

Promantra Team:Manager Operations, Finance & IT

Partner Team:Accounts Head, Tech In-charge, Operations SPOC

Partner business assessment, gap identification in addition to gaining a complete knowledge of clients’ AS-IS processes. Detailed Should-BE process Mapping

Detailed process Maps along with Standard Operating Procedures (SOPs) are prepared /updated detailing escalation procedures. Where applicable Training plans and content are detailed. SOW & SLA metrics are detailed & signed-off by both parties

Cold-testing to check technology setup (incl. Business Applications). The Account Head or Operations Manager for the Accounts team at India undergoes training.

Partner audits and evaluate Pilot teams production. Reporting structure and formats are finalized. SLA targets are revisited and finalized

Complete processing of all sub-processes is carried out by the Indian operations team Standardization of processes, process control systems.

Integration with Promantra Integrated Management System (IMS).

Continuous process improvements

Promantra provides a ramp-up plan that ensures client expected quality and TAT are met

Transition & First Time Outsourcing model adaptive to

existing systems in place

Team Identification

Process Mapping

Documentation

Pilot Test, Training, Reporting & SLA

Go Live

Transition Methodology

Transition Methodology

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Chirag Patel

Director – Business Development

Email: [email protected]

Phone: 1-732-917-7077

Contact Us

Thank You


Date post:	19-Aug-2015
Category:	Healthcare
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