How A Telemedicine Solutions Company Got Quick And Accurate ICD Audit Services

The Client

The client is a renowned telemedicine solutions company that empowers physicians, health institutions and patients with a complete mobile health technology platform. It offers cloud-based solutions to facilitate the doctor patient relationship, and automated billing for recurring and one-time fees. The company is a turnkey partner for organizations looking for low cost and fully branded telemedicine solutions.

Business Need

To meet their strategic goals, the client was looking for a dedicated team of professionals that can audit physician’s orders/prescriptions with accuracy and speed. The prescriptions were for cancer patients and hence called for absolute confidentiality in processing critical information related to diseases and diagnosis. Since the client was a telemedicine service provider, familiarity with ICD (International Classification of Diseases) codes was a prerequisite. The online orders and prescriptions had to be audited on parameters ranging from patient information, signatures, date of service, history of illness in patient’s family to verification of ICD codes and many other criteria. After the final audit and approval by the client, these test prescriptions and orders had to be sent to related insurance companies for payment approvals.

Challenges

Finding auditors with knowledge of ICD codes was difficult for the client
Employing a team of such resources locally was a cost prohibitive proposition
The in house auditors at SunTec did have knowledge of ICD codes but needed further training to meet the clients requirements

As the insurance companies could decline the payment claim at the slightest pretext achieving 100% accuracy in audits was an absolute must
Extensive and seamless collaboration with the client in real time was necessary
Client wanted the team to scale up the learning curve quickly

Solution

The audit team at SunTec got a comprehensive understanding of client’s exact requirement and deputed four of its most efficient and experienced resources to work on it. Working on a 24/7 basis the team took exhaustive training sessions with the client on ICD codes and the audit process. Within a short span of time the team was on its own conducting full scale audits of physician orders/prescriptions. In the beginning the client approved the audits, but soon the SunTec auditors started approving the audits independently. The client was happy with the performance of the team and recently scaled up the team from 4 FTE to 6 FTE.

Business Outcome

The result of a successful business is a happy client and the team at SunTec made it happen. With this ongoing project, the client was able to:

Get easy access to the most suitable skill sets
Leverage labor arbitrage to save operational cost
Get an extension of his team in India
Reduce time to market by making the most of the time difference
Get accurate audits done within a quick turnaround time

Ensure safety and security of critical data with ISO certified audit process
Stay ahead of competition with bespoke physician order audits
Focus on their core business of empowering medical practices, patients and healthcare providers

About SunTec India

SunTec India is a reputed name in the outsourcing arena since 1999 with an experienced pool of 1,500 full time employees. We offer bespoke services, strict SLAs and auditable processes to industries across the board. We have a proven track record of serving a world wide clientele of 7,800 organizations, including Fortune 500 brands. As an ISO certified service provider with robust infrastructure we offer flexible and scalable outsourcing models.