Eindar Khant, CEO, Passage Health International
Managing international patients can be a daunting endeavor to hospitals. As healthcare institutions lack the necessary resources and time, they struggle to deal with global insurance policies, cultural differences, language barriers, and legal issues. To address this challenge, they often reach out to medical billing partners. However, an estimate by the American Medical Association reveals that most commercial payers have an average of 200,000 to 300,000 coding guidelines embedded into their claims processing systems. Despite following these guidelines, almost 4 to 18 percent of the claims submitted are denied with zero payments because of various methodologies that commercial insurance companies use to edit claims. The claims submitted to insurance companies are deemed nonstandard because foreign providers are unaccustomed to the U.S. billing methodologies and coding guidelines.
Set against this backdrop, Florida-based Passage Health International (PHI) bridges the gap between healthcare providers and the U.S.-based insurance companies with its highest quality of medical billing services. “Our objective is to mitigate claims losses for clinics and hospitals that regularly manage international patients and allow them to focus on what they do best—providing excellent care,” begins Eindar Khant, CEO of PHI.
PHI manages international medical claims for hospitals and ensures that their billing and coding methodologies are on par with the industry standards. PHI’s wide range of services for medical providers includes everything from verifying insurance coverage to receiving the final payments from the insurer or even the patients. PHI ensures that its partners are paid properly and quickly when treating foreign patients.
We possess the expertise and knowledge to process and manage claims regardless of the patient’s origin or the location of their insurance company
If a patient presents an insurance card, healthcare providers must have confidence that the insurance company is creditworthy in order to offer direct billing and ensure that they are going to get paid. As an extended business partner, PHI mitigates the risks that clients face by providing them with the full picture of insurance companies and their policies. For instance, if PHI comes across an insurance company that is not creditworthy, the company informs its clients about the same to enable them to make smarter business decisions. This way, PHI ensures that the client focuses on providing quality care rather than worrying about the payments for their services. “We possess the expertise and knowledge necessary to process and manage claims regardless of the patient’s origin or location of their insurance company,” states Khant. Besides managing billing services, PHI also offers concierge-level services such as care coordination for the patients. In situations where patients require a higher level of care and need to be moved to a different facility, PHI works with the patient’s family and the insurance company to ensure an effortless experience when being transferred to a new hospital.
From the time a patient enters the emergency room to settling the payment, PHI manages the entire episode of care from start to finish, which includes the financial, legal, and logistical aspects. Once a patient is discharged, PHI reviews the medical records, hospital charges, and forwards it to be reviewed by an audit team to ensure that everything that the patient is billed for is medically necessary and indicated properly on the bill. Khant points out with pride that due to their in-depth review, the claims submitted by PHI have higher chances of being approved and paid with a denial rate of less than one percent.
Apart from assisting clients in mitigating risks, PHI also has an in-house legal team that specializes in recovering payments from problematic payers and patients. The legal department manages the litigation side and ensures timely and cost-effective results. With partners like PHI who are at the forefront of providing healthcare providers with quality medical billing services, the risk of not being reimbursed by insurance companies is effectively negated. According to Khant, the value that PHI brings to the marketplace has been instrumental in the company’s growth and their 100 percent client retention rate.