Data Marshall Promotion

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Healthcare Services Division
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TBS is a Strategic Advisory and Operations
Consulting Firm, providing onshore/offshore
outsourcing solutions to our clients with quick
scalability and delivery capability, having a
committed and very talented team of
professionals. Within our Healthcare Division we
help our clients by providing them with solutions
that will improve their business processes so
they can concentrate on providing better
healthcare services. We have a history of client
retention with successive years of contract
renewals.
TBS has assembled a group of organizations well
regarded in their individual fields to create the
TBS Healthcare Consortium. Our mission is to
improve many of the critical issues facing
Healthcare today! Healthcare organizations that
engage with TBS have available to them through
the Consortium additional top tier companys
committed to improving many of the issues
troubling Healthcare..
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Transnational Business Solutions, LLC and Data
Marshall, Inc. work together with a common goal
of providing improvements to healthcare services
as part of the TBS Healthcare Consortium.
Engage with us to improve your bottom line using
the
Underpayment Recovery Services
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Contents

• Corporate Profile
• DM Service Offerings
• Provider Services
• Payer Services
• Revenue Management Services
• Underpayment Recovery Services
• Underpayments Recovery Areas
• DM Key Differentiators
• Value Proposition
• Sample Engagements
• Underpayment Recovery

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Corporate Profile
Founded in 2002 headquarters in NY
Inception
Near shore and Off Shore delivery centers,
Headquarters based in NY and delivery centers in
Ann Arbor, MI Hyderabad, India
Global Delivery Centers
Clients range from Small entities to Fortune 100
organizations in USA, UK Canada
Clients profile
Service Portfolio
HealthCare Insurance Payer Provider services
ISO/IEC 270012005 (BS 7799 - Information
Security Management System ISMS Certified)
security standards. HIPAA Compliant Organization
Data Security
Six Sigma based methodologies for Transition,
Quality Process efficiency LEAN programs for
process improvements
Quality
Global Delivery Model, which delivers 24 X 7
services
Delivery
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Healthcare - Provider Services
Data Marshalls current experience in the
Provider domain comprises of service offerings in
the following process areas
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Healthcare - Payer Services
Data Marshalls current experience in the Payer
domain comprises of service offerings in the
following process areas
POLICY ADMINISTRATION
NETWORK MANAGEMENT

• Enrollments - New Enrollments updates
  maintenance
• Eligibility Management
• Pre-Ex COB information verification

• Out-of-Network Claims Negotiation Support
• Provider Contracting
• Contract Maintenance

PROVIDER DATABASE MANAGEMENT
CLAIMS MANAGEMENT

• Claims Data Entry
• Pre-Adjudication
• Claims Adjudication services
• International, RX CDH claims processing
• Claims Re-pricing
• Claims Adjustments

• Provider updates Data
• maintenance
• Facility Data maintenance
• Manual Provider matching
• Provider Credentialing Support

PAYER ANALYTICS
UTILIZATION MANAGEMENT

• Payment Integrity Audit (Overpayment Recovery)
  Services
• Claims Reconsideration
• Hospital Bill Audit
• Code Review DRG Audit

• Physician Referral review process
• Pre-auth generation
• Inpatient Admission notification

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Revenue Management Services
Data Marshall currently offers the following
end-to-end Revenue Management services to the
hospitals physicians/physicians groups in the
Provider domain.
DM users login remotely to the client servers,
through a secure connection, access the data
needed to perform the various functions.
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Underpayment Recovery Services - Overview
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Underpayment Recovery Process Flow
The clients have the option of conducting a
second level review of the underpayments
identified, prior to DM initiating recovery
efforts
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Underpayment Recovery Areas
Sample underpayments for an existing client
A 360 Degree review approach is adopted to
identify underpayments from a billing, coding
reimbursement perspective
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Healthcare - Key Differentiators

• A decade of proven service track record
• End-to-end expertise on Payer and Provider
  domains
• Expertise spanning across the value chain ranging
  from low-end transaction services to high-end
  audit analytical services
• Thorough understanding of the claim life cycle,
  enabling us to understand the nuances of Claims
  Management
• Experience expertise in the niche segments of
  Code Review, DRG Audit Payment Integrity Audit
• Experienced staff comprising of certified
  analysts Professional Medical doctors as DRG
  coders
• Customer satisfaction through our ability to
  thoroughly understand the client business
  requirements and highly effective delivery
  capabilities

Benefits to Clients

• Recovered underpayments of over 6Mm in a period
  of 18 months for a leading hospital in New York
• Revenue increase ranging from 5 to 8, with
  improvements in collection days FPCR
• Achieved cost savings of over 40 for clients
• Significant Improvement in TAT, Payment
  Realization reduction of AR days for Providers

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Value Proposition
Value Proposition
Revenue enhancements cost optimization
Improve collections by up to 5 through our RCM
expertise
Data Marshall services can be used independently,
or as 2nd or 3rd pass vendor in the Audit sphere
Experience in the Payment Integrity Audit
services, recovering underpayments of over 6 Mm
Comprehensive domain expertise spanning the
entire spectrum of Provider services
Business Process Optimization
Process Enhancements
High end niche services
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Payment Integrity Audit Case Study
The client is a multi-site community healthcare
system located in New York
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Redefining Business Approach

Building Relationships Learning
Together Knowledge Management
BEST

Process Improvements Productivity
Gain Performance and Profitability
POSSIBLE

Organizational Fit Openness and
Accountability Ownership and Responsibility
OPTION
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Building Relationships Learning
Together Knowledge Management
Contact us today to find out how TBS and Data
Marshall can improve your bottom line with no
upfront costs to your Hospital! Tim
Kirsch Consulting Partner Transnational Business
Solutions, LLC 45 West 34th Street Suite 1107 New
York, NY 10001 800-362-8691 tkirsch_at_transbizsoluti
on.com