WELCOME

Management Trainee Program

Week-
1
 PROCESS FLOW

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INTRODUCTION MEDICAL DME & HME RCM CASE
BILLING CONCLUSION
BILLING STUDY
SCENARIO 1 ,
2
 Charlotte, North Carolina ,USA

HME Billing and Process

Outsourcing
 Prochant is the nation’s leading HME billing and process outsourcing company.
 Our highly-skilled team helps providers become more profitable by outsourcing
or enhancing front- and back-office processes.
 We rapidly implement changes and proactively monitor metrics to ensure client
success.
What we do ?

MEDICAL
BILLING

DME &
HME
 REVENUE CYCLE MANAGEMENT
 Revenue cycle management (RCM) is the financial process, utilizing
medical billing software, that healthcare facilities use to track patient care
episodes from registration and appointment scheduling to the final payment
of a balance.
 REVENUE CYCLE MANAGEMENT

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TRANSMISSION ACCEPTANCE
DATA ENTRY EV/PA ORDER BILL
OR DENIAL
CONFIRMATION GENERATION /
MANAGEMENT
BILLING REVIEW
 CASE STUDY- Scenario1

VERIFICATI ORDER /
ON INTAKE
 Patient Name-James
Johnson
 Age – 68 PROCEDUR
ORDER
 Insured-Primary, Secondary AL CODE-
CPT/HCPCS/DX PROCEESING –
CONFIRMATION/FULLFI
 Hospitalization - April ’24 CODE
LLMENT

 Diagnosis- ICD-10-CM Z98.84

BILL
 SNF-100 Days DENIAL/AR
GENERATIO
N
 CASE STUDY- Scenario2

VERIFICATI ORDER /
 Patient Name-RACHEL ON INTAKE

GRANGER
 Age – 50(Dis-abled, Kidney PROCEDUR
ORDER
failure) AL CODE-
CPT/HCPCS/DX PROCEESING –
 Insured-Primary CODE CONFIRMATION/FULLFI
LLMENT
 Hospitalization – Dec’24
 Appealed – 2 times BILL DENIAL/AR
GENERATIO
 Diagnosis- ICD-10-CM C64.9 N
 CONCLUSION

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ARJUN RAHUL INDHUJA PRASANNA

MEDICAL BILLING / REVENUE CYCLE CASE STUDENY CASE STUDENY
HME / DME MANAGMENT SCENARIO 1 SCENARIO 2
ANY QUESTIONS ?
THANK YOU