Healthcare and Hospital Administration

Round the clock coverage for most critical industry

Hospital administration is the most complex applications of management skills. This is because of the criticality associated with lives of patients are involved. The core objective of hospitals is to provide best of healthcare services to patients. In general, apart from actual healthcare services, hospital administration lands up consuming huge amount of time in non-healthcare related activities associated with record keeping and financial clearance of patients.

An effective way to keep the focus on core objective of healthcare services is to identify repetitive clerical / administrative tasks and delegate those to third parties. Some of the activities that are delegated to third parties by hospitals are as follows.

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1. Financial Clearance Audit – This is an important part of patient’s treatment and is time sensitive. It is important to validate insurance (Medicare, Medicaid, etc.) status of patient well in advance, seek necessary authorizations from concerned providers, coordinate with patient or patient’s relatives to get things sorted well in time to ensure that treatment is scheduled on time. Dedicated teams working on these verifications improve turn around time of financial clearance thereby offering quicker assistance to patients. Suma Soft healthcare experts are highly experienced validation of Medicare, Medicaid and Other Private insurance policies and coordinate with patients in case of insufficient coverages, renewals, etc. 

Team has proficiency in Financial Clearance activities such as Preparation and Issue of Authorizations to Primary Care Providers, HDX for automatic Eligibility verification, Verification on third party websites such as Change Healthcare, NIA, Availity, Olive, AIM, Evicore, Documenting the evidence in Healthcare Management System for future records, etc.

2. Accounts Payable – We offer services on following sub-functions within Accounts Payable function.

Indexing / Routing of Communication – Our team of AP Analysts review emails received for Accounts Payable Department and route them to concerned queue for further processing and pay out. Type of emails received are generally Invoices, EDI Invoices, Credit Memos, W-9 forms, Shipment Notifications, Packing Slips, Order Confirmations, Account statements, etc. The activity involves splitting of invoices if multiple invoices are received within same email.

Reconciliation – Our PA analysts carry out a detailed reconciliation of outstanding invoices as per request from vendors when Account Statements is received. 

Fixed Asset Register Entries – Based on invoices received for purchase of Fixed Assets, Register of Fixed Assets is updated accordingly. Updating of disposal status for assets in system.

3. Accounts Receivable – This is an important function within Finance dept. Reconciliation of Accounts Receivable amounts, timely reporting and follow ups for outstanding funds and recovery of money within stipulated amount of time plays a crucial role in financial success of hospital setups due to heavy costs involved. Our experts have hands on experience in accurately deriving AR balances for Patient Accounts, Insurance Providers as well as Pharma companies in cases of Clinical Trails. As a part of Periodic Reconciliation, we conduct a thorough review of Unbilled Items, Billed Items, Advance Payments, and Deferred Revenue to arrive at accurate Accounts Receivable amounts.

We have experience in preparation of invoices, creation and submission of eCRFs (Electronic Case Report Forms), application of funds and other bookkeeping functions of Accounts Receivable dept.

4. Budget Review for Clinical Trials – For hospitals involved in Clinical Research activities, the revenue associated with Clinical trials plays a very important role. To ensure that estimated revenue for financial year is calculated accurately, it is important to have budget of clinical trials prepared accurately as per contractual terms with Sponsors and updated based on the amendments in contracts. Our team of analysts have experience of preparation of budgets, corrections to it based on any amendments and audit of budget based on contractual terms.   

5. Healthcare Information Management – Substantial amount of data for each patient needs to be documented and stored for specific period of times by each hospital. Healthcare Information Management dept has the responsibility of ensuring that all necessary data is properly documented. This includes functions such as Identification of document bucket, Bookmarking the document, Indexing / Stacking it in respective buckets. The HIM department is also responsible for retrieving and sharing necessary data when a ROI (Request for Information) is received from authorized parties. Suma Soft HIM experts have proficiency in working on HIM functions to assist our clients in turning around any requests received by this department within specific amount of time with highest accuracy.

6. Pre-admission Patient Access Document Indexing – When a new patient is enrolled and is about to be scheduled for First Appointment, hospital administration team is required to setup Patient Record in system and ensure that all documents received prior to visit are properly indexed in respective categories. Our team of Patient Access Analysts are proficient in indexing of various documents such as Pathology Reports, Radiology records, Lab Reports, Clinical Notes from PCP, Cardiology report, Diagnosis details, etc.

CRM Proficiency – Our analysts have proficiency in working on the following CRMs /  systems.

  • Oncore
  • Cerner
  • Soarian
  • Change Healthcare
  • Trace

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