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Quality Standards

Quality Standards

Quality Standards

In the BPO industry, quality assurance refers to the methodical techniques and processes used to guarantee that the services meet or surpass client expectations and quality standards. In order to increase customer satisfaction, it entails monitoring, evaluating, and improving the various components of service delivery. Quality assurance (QA) in call centers/data processing centers is a process that ensures you're performing according to the standards of your company. This is done by monitoring and evaluating your team based on the key performance indicators (KPIs) that you have set.

Creating quality standards is the first stage in quality assurance. A collection of rules called quality standards describes the expected caliber of the service being rendered. In a BPO, the client and the BPO provider determine the quality standards. Both parties must formally specify and concur on these requirements. In most circumstances, the vendor should ideally adhere to the client's standards, but when the vendor sets extraordinarily high criteria for delivery excellence and compliance, things take on a life of their own and raise the bar for client deliverables.

The healthcare sector's aspirational back office billing service supplier is MF. The establishment of the activities includes quality analysis and control, and MF has started the necessary quality and security measures in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Quality Analysis: For timely and accurate payment, accuracy in transcribing, coding, and claim charge information is essential. Insurance companies are quick to reject a reimbursement if the information is wrong. In fact, clerical errors are thought to be the cause of as many as 80% of denied claims.

The process of routinely assessing the level of the service being rendered is known as quality monitoring. A quality assurance team often performs quality monitoring in a BPO. To assess the level of service quality, the team will make use of a variety of monitoring technologies. Software for monitoring calls, performance indicators, and client feedback are a few examples of these resources.

Medical billing quality control process: MF follows TWO TIRE quality check on all billing work.

  • Medical Billing – Level I- Floor QC: The entire demo and charge entered is quality checked by field by field for errors and checking for client specifications error by the floor QA team.
  • Medical Billing – Level II- Random QC: MF senior QC team who monitors entire operations randomly picks demo and charge entered by the each billing staffs every half hour and quality checks for error and reporting back to the account manager and billing staffs.
    • Verify for typos
    • Billing mistake
    • Specification mistake
    • System flaw

Everyone on the team @ MF receives weekly quality audit reports, and the billing staffs' work is regularly tracked and evaluated.

Quality assurance (QA) in data processing and call centers is a process that ensures you're performing according to the standards of your company. This is done by monitoring and evaluating your team based on the key performance indicators (KPIs) that you have set.

Due corrective measure are taken to ensure the mistake is not repeated

  • Understand the client requirements
  • Planning the process and creating specification and process documents
  • All specification on process documents exchanged between client so that we remain same page on every process
  • The team/individual will be given training on the process specification as per approved client document

Everything happens according to plan in an ideal world but glitches are probable in the actual world. Adjustments are performed for this stage to enhance the corrective action procedure. The system is adjusted in order to make nonconformance reliably discovered, assessed, and corrected. Through continual improvement, the objective is to transform corrective action management into a reliable and efficient procedure.

Are you look for a right outsource partner for your Insurance Verification, Patient Answering, Medical Transcription, Medical Coding, Demographic Entry, Claims Entry, Submission of Claim, Payment Posting, Denial Management, Accounts Receivables service and Revenue Cycle Management. If you are interested to outsource any for process to MF please send us an inquiry and we’ll get back to you with apt solution.