Technologies that drive
Growth and Productivity

Value Enhancing Solutions for Providers and Payers

Healthcare Management Expertise by Leveraging

Revenue Assurance

Technology

Cognitive Science

BPM

Exdion’s Revenue Assurance strategy helps healthcare providers arrest revenue leakages and collect payments securely and efficiently. And all this, while improving the overall patient experience. We focus on standardizing the processes, systems and employee practices that drive financial outcomes. Exdion uses Lean, Six Sigma and Service Quality frameworks to make every process lean. We, thereafter, use automation tools like RPA and BOTs to reduce manual workflows and improve operational efficiency in each of these areas:

• Intake & Authorization (patient registrations, physician referrals, pharmacy orders and payors authorizations)
• Coding & Billing (coding, building claims, submitting batches and fixing rejections)
• Denials & AR Clean-up (responding to pending and denied claims, appeals and additional documentation)
• Posting & Reconciliation (gathering 835s, converting paper EOBs, posting payments and reconciling payments)
• Performance Analytics & Reporting (business insights and reporting)

Our strategy also helps providers:
• Effectively collect out-of-pocket expenses -Patient dues and BAI (Balance after Insurance)
• Improve billing transparency to reduce patient frustration
• Deliver an overall superior patient experience

Practice Setup and Front Office Audit

Exdion evaluates practice setup and front office process to eliminate waste, rework, waiting time and aim to provide high patient experience. Practice setup and front office play a key role in acquiring new patients, hassle-free appointments, optimized demand and supply matching. Our audit helps healthcare service companies improve their operational metrics on several fronts that include revenue per patient, scheduling mismatches, cancellations, no-show rates, etc.

Healthcare service providers benefit from optimal time management, higher realization of revenue, efficient matching of supply and demand, technology leverage that can result in higher efficiency and service experience. Our consultants conduct service walkthrough and benchmark against the best-in- class healthcare service delivery models to identify as-is efficiency, gaps and improvements.

Data Integrity Audit

Clinicians are mandated to audit adherence to clinical policies and procedures. The unavailability of right data can lead to erroneous results. Improper documentation can lead to coding errors and costly billing errors. Exdion offers a data integrity audit to check the accuracy of data flowing through billing and other systems. Accuracy and integrity of data flowing through the systems is key to a healthcare service provider’s decision-making capability.

Healthcare service providers gain from seamless service operations, reliable data processing and straight-through processing opportunities. Improvements based on the audit leads to adoption of the best healthcare practices and smooth CMS audits and compliance.

Revenue Assurance Audit

The audit is useful for healthcare service providers to analyze the current status of Practice Management, identify gaps and prioritize improvements that can prevent revenue leakage, and maximize customer experience while retaining high quality service levels.

Revenue assurance audits can indicate methods to benefit from lower costs including centralization, outsourcing and automation. Our recommendations may also include leveraging advanced technologies like Artificial Intelligence (AI), Machine Learning (ML), E-bots, Robotic Process Automation (RPA), and cloud technologies to eliminate human errors and other constraints that limit scale and growth.

Patient Experience Audit

Patient experience audits help our clients significantly to improve customer satisfaction and increase loyalty. Our consultants help companies understand patient experiences, pain areas, service irritants, pre-encounter and post-encounter engagements. Healthcare service providers can choose from automation and customer portals for self-service straight through processing to reduce waiting time and improve patient engagement.

We conduct primary research and service walkthroughs to uncover the voice of customers, in parallel to secondary analysis of the process, information flow that affects service quality and moments of truth. Healthcare service providers can use the experience of audit results to implement appropriate remote monitoring systems that help improve patient outcomes.

Partners and Payers Audit

Patient experience audits help our clients significantly to improve customer satisfaction and increase loyalty. Our consultants help companies understand patient experiences, pain areas, service irritants, pre-encounter and post-encounter engagements. Healthcare service providers can choose from automation and customer portals for self-service straight through processing to reduce waiting time and improve patient engagement.

We conduct primary research and service walkthroughs to uncover the voice of customers, in parallel to secondary analysis of the process, information flow that affects service quality and moments of truth. Healthcare service providers can use the experience of audit results to implement appropriate remote monitoring systems that help improve patient outcomes.

Healthcare Revenue Cycle Management Transformation

RPA works best with data and rule-based processes. It is easy to implement and can efficiently carry out repetitive tasks which are otherwise prone to human error. RPA can be applied to healthcare including account management, claims processing, underwriter support, customer support, billing, collections, reconciliation, and reporting and analytics consolidation. We need to identify precisely where RPA can be applied within the healthcare ecosystem.

RPA automates accounts payable and receivable processes and helps to improve the billing process. Patients can be notified of what they owe, and payments can be collected, and accounts settled quickly. RPA performs this at a much faster rate than a human employee.

Revenue Cycle Management is heavily reliant on manual effort because of denials and the need to correct the claims. RPA can help identify the healthcare claims that do not meet the stipulated requirements and facilitate claims review. Claim denials are preventable and can be corrected for payment. The cost of deploying people to handle denied claims far outweighs the reimbursement value. RPA, in comparison, offers quick and reliable service in recovering large amounts in Accounts Receivable that may have been written off/gone unpaid. RPA does this by identifying patterns of claim denials and reducing the chances of occurrence, saving manual effort and time. Deployment of RPA thus results in reduced processing time, reduced processing errors, reduced denials and reduced write-offs. In this way, healthcare providers maximize their revenues besides saving their resources.

How can you benefit from Robotic Process Automation and eBOTS?

• Predict Better, Collect more, Collect Faster
• Improve Patient Experience – Focus on Patient Care
• Realize significant cost savings – Eliminate manual efforts and costly errors
• Independent of EHR, PMS or other technology in place
• Enables better use of existing technology
• No complex HL7 or API Integrations – simple Straight Through Processing

Evaluate Process

  • Owners capacity
  • Workloads
  • Challenges
  • Areas to improve

Rationalize  Process

  • Build capabilities
  • Governance structures
  • Right person for the right job

Deploy KPI

  • Measure at all levels
  • Communicate success

Benefits Of Exdion RCM Transformation

Workflow Standardization

Error prone to Error free systems

Automation through RPA, AI, ML leading to high scalability

Cost optimization

Revenue Maximization

Thinking of ways to improve your business efficiency?

Revenue Cycle Management Automation

EOB Downloads

Billing companies manage a master spreadsheet with carrier credentials and payment information. Based on the lineup set for each carrier set by the billing companies, the user has to manually login to several carrier portals to find if there is any new EOBs received and download the same referring to the previous downloaded history.

If there is a new EOB available then the user must download it to the appropriate path and designate it to the respective user to post it on to their PMS. The user also has to capture the payment details, carrier details, date of download and update it in the master spreadsheet.

PROCESS FLOW

Create a master spreadsheet with all the login details for each carrier.

The BOT downloads the EOBs from different carrier portals and saves it in the specified path with the naming convention.

The BOT checks the previous date of download in the master spreadsheet and then identifies if there are any new EOBs received.

The BOT captures the below information and saves it in the master spreadsheet
1.Payment date 2. Check details 3. Date of download 4. Carrier name

The BOT downloads the EOBs from different carrier portals and saves it in the specified path with the naming convention.

CHALLENGES

  1. Time & Effort

  • Studies show that completion of this activity manually takes a minimum of 80hrs in a month.

  • Logging into several carrier portals manually to check if there is any new EOBs received is a cumbersome process.

  1. Human Errors

  • Typos while updating information on the master spreadsheet.

  • Saving EOBs in the wrong path.

  • Missed downloading EOBs.

BENEFITS

No human dependency &
hence no errors

Saves Time

No room for TAT breach in-case of posting the payments or denials

Payment Posting Automation

Today, hospitals, medical practitioners, and clinics face an arduous challenge every on the paper work they need to do. Remittance Paperwork, which accompanies the payments received from insurance payers is one of the major paper work that happens.

On an average, more than 20% of the medical payments today are posted manually due to the inability of payers to provide an electronic remittance advice (835/ERA) back to the providers. This in turn, costs providers a substantial amount of time and resources.

This process, also known as Payment Posting, is extremely crucial, as any wrong entry can result in inaccurate billing leading rejects or prolonged communications.

CHALLENGES

  • Research shows that on an average, about 160 hours is the time spentby one FTE for manual posting for a month.
  • Logging in to several billing applicationsto post the payments and denials received, electronically and manually is an onerous & tedious activity, sometime prone to human errors.
  • Errors are highly likely to occur, while updating the information in the master spreadsheet.
  • The month end manual reconciliations is a challenging activity and takes at least week to complete.

Exdion Payment Positing Solution

Exdion has developed an Artificial Intelligence (AI) based BOT that smartly post the payments through 835file and retrieves EOB’s from various carrier websites and the payments.

BOT not only validates each payment but will notify the supervisor in case of any deviations.

PROCESS FLOW

BOT logs in to billing application

BOT will 1: Electronically post the payment through 835 file 2: Manual EOB's are retrieved from career website and also from lockbox and post the payments

BOT then goes to each transaction to validate the payment posted.

Will trigger the exceptions to the supervisor

BOT will reconlise the amount posted

BENEFITS

  • No Errorsdue automation replacing manual entry
  • 100% accuracy in PaymentPosting
  • Easy matchingof Payments to Remittances.
  • Completely automated entry, verification and post of payment
  • Huge savings in Administrative Costs, and Transactional Time
  • High Compliance adherence.
  • Ability to quickly sort between Paid and Unpaid ERAsfor quick & smoother accounting.
  • Increased Rate of PaymentCollection by being able to specifically identify claims that are underpaid / denied.
  • Easy & faster PaymentManagement from multiple insurance companies.

Avg. time spent by 1 FTE to complete one month’s PP activity

160 Hrs.

Percent of Medical Payments done manually

20%

Accuracy achieved by BOT

100%

Future is now Here

ExdionAiR

ExdionAiR, is a smart Cognitive Science-based tool, that takes away the manual process challenges and associated complexities involved in checking the status of the claims through several payor portals. ExdionAiR is a bot that makes healthcare service providers AR process smooth and seamless. ExdionAiR offers greater financial flexibility for managing both short-term routine challenges and long-term sustainability.

ExdionEVA

ExdionEVA, a smart Cognitive Science-based tool, addresses all challenges and complexities involved in the verification process of the patient's copay, Co-insurance and Deductibles through payor portals.

Providing Significant Insights through Analytics

In today’s data-driven age, healthcare decisions are increasingly transitioning from opinion and intuition based to informed ones based on data and analytics. Analytics play a big role in clinical decisions and diagnostic support. Predictive analytics support physicians in the early detection of critical diseases. Patient data analytics analyzes clinical data and provides deep insights into the patient’s health condition. Such insights help to provide tailored care, reduce costs of care, manage patient health and improve patient engagement.

Exdion’s Analytics helps you to identify relationships that influence business outcomes and develop actionable management responses that are insight driven. We help companies transform to a data driven organization and realize the benefits therein. As part of our Analytics services, we deploy RPA to extract data from patient portals to monitor patient care after discharge besides designing programs for future patient care. We can monitor patient health on an ongoing basis by retrieving information from wearables, lab results and health apps. This shall improve outcomes and reduce potential readmission. By deploying predictive analytics, Exdion ensures that patient treatment is personalized the first time they are admitted. This, in turn, reduces the incidence of costly readmissions. In a value-based market, such benefits are much desired. Our Analytics Service targets delivering holistic data management, insight generation and modeling and much more. Exdion provides analytics tools for:

1. Holistic data management: Ingestion, Data, Characteristics & Interactions and Data Quality
2. Insight generation and Modelling: Visual Maps, Data density – Outliers / anomalies
3. Segmentation, Classification, Regression and Forecasting models

Managing the health of patient populations requires a proactive approach that simpler data analytics built into an EHR simply can’t provide. We deploy our proprietary automation tools to access clinical data, enabling the solution to draw out relevant information that enhances patient care, all while automating certain processes for improved efficiency. Our predictive analytics solutions offer research-driven data science, clinical actions and demonstrable results to deliver maximum value. Many healthcare organizations struggle to understand how predictive analytics can be effectively used to drive these clinical and financial results. Here are a few benefits one can expect-

• Improve patient safety, increase operational efficiency, and boost patient satisfaction by accessing new insights
• Reduce Patient Length of Stay
• Reduce Readmissions
• Improve Healthcare Resource Allocation
• Predict Emergency Department Visits and Hospital Admissions
• Improve Outcomes and Lower Costs

Analytics requires accessing data from disparate sources in differing formats and run algorithms to gather insights. This would require significant human effort and time if done manually. Exdion uses RPA tools to automate and integrate disparate systems. Exdion also has developed and deployed Bots to automate the process. Exdion Bots are easy to code, deploy and scale. These bots can work seamlessly with the existing applications and escalate fallouts to their human colleagues. Exdion is also extending learning and NLP capabilities for Bots to make them more intelligent.

Enlightening Artificial Intelligence
Empowering Disruptive Technologies

Strategic Engagement towards Business Excellence

Exdion offers flexible engagement models depending on client requirement.

*The activities mentioned under each engagement models are only illustrative examples.
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Job title: Digital Marketing Specialist Reporting to: Manager, Marketing Experience required: 0-3 years Primary Responsibilities:
  1. B2B Social Media Marketing
  Platforms: LinkedIn / Twitter / Instagram / Facebook / Google+ / Quora / etc.  
  1. B2B Email Marketing
  Tools: Mailchimp / Constant Contact / SendGrid  
  1. Internal & External Communication
 
  1. Website(s) Management
  Tools: Google Analytics / WordPress / Yoast SEO / etc.  
  1. B2B Market Research
 
  1. Miscellaneous
  Brownie points for:       Company Description Exdion Solutions is a global B2B tech-led consulting & product organization specializing in the healthcare and insurance domains. We build & market, state of the art technology (AI, ML, NLP, etc.) products & and have offices in US & India.

Manager Business Development

Summary

Experience:

9-14 years of experience in sales of Technology Product Selling

Experience in selling IT products in North American market essential

Experience in selling IT products related to Insurance Industry will be advantageous

Education:

Job Description

Ideal Candidate Profile

Compensation

Will be commensurate with the experience level and internal benchmarking


Apply Now

AR Caller- Job Description
Hiring No. :5
Summary
Will be involved in calling the US insurance representatives for analyzing the Claims and updating the Claims status.
Experience –Minimum 6 months to 3 years of experience in AR calling/Analyst.
Duties and Responsibilities:
Mandatory Skills: EDUCATION Graduates preferred / 10+2, PUC also can be considered if they have sufficient experience.
GENDER SPECIFICATION: Any CTC (Based on Experience and Interview)[Including benefits]
SHIFT TIMINGS
Note:  Preferably candidates located in North Bangalore if not, willing to relocate.
Work Location Exdion Solutions Pvt Ltd STC Trade Centre, 5th Floor, Nandini Layout, Bengaluru, India – 560096. Ph No: 080 46585000
Apply Now

L.S Ram

L.S Ram: Managing: Director & CEO Ram is one of the co-founders of Exdion and has served as President and CEO since inception. Under his leadership, Exdion has consistently set new standards in the field of process management and quality excellence. He brings over 30+ years of experience and holds a post-graduate degree in Computer Science and is a Chartered Accountant. He is also a Certified Information Systems Auditor from ISACA, USA and a Certified Associate of Insurance Services awarded by “The Institutes” (AICPCU), USA.