Health Care RCM and Medical Coding Service Provider Start-Up in India

The investment project idea is to offer revenue cycle management services to hospitals. The services include medical coding, billing, payment posting, charge posting, and patient calling. The Funding is required as a linear Capex investment. Project Start Date: 7th Dec. (Project Delayed Due to lack of funds).

The What?

• To be a Top-5 RCM and Medical Coding service provider handling 30 to 35% of all RCM from India by 2014
• To be the leading Indian KPO in medical coding & training facilitation by 2014
• Strong Differentiation through incubation o enhanced expertise in healthcare, competency development through highly engaged employee retention programs with amalgamation of advanced technology
• Service provision across all specialities within the scope of hospital and physician medical billing

The How?

• Create an AAPC / AHIMA compliant and six sigma certified RCM company comprising of accomplished coding and RCM professionals involving intense training methodologies, steady and preservative documented SOPs, expertise in HPMS (Next Gen, Medical Manager, Flex, IDX, QSI)
• Develop and invest in creation of standalone market proven HPMS which is easy to use both for the clients and the suppliers
• Launch specialised compliance regulatory training modules for clients to be RCA compliant
• Focus on providing knowledge driven service offerings across the US healthcare fraternity

Clients

• The client-1 is the chain of clinics in US. We are going to start with 2-clinics (240 FTEs in total) & expect to add another clinic (approximately 100 FTEs) in the month of June 2012. The signed SLA has been received. Further intimation from client for final go is in the pipeline.
• The client-2 is a group of providers. We’ll start with 150 associates in the month of January 2012. Then we will add another 100 associates in the month of February 2012. The SLA has been sent to provider’s group for final review. Our resident representative on their board is in close communication with them for addressing their Qs and Cs if any.
• Both clients are hooked through direct and intimate personal contacts.
• The SLA tenure will be of 5- years with both clients. We’ll be providing RCM services (Coding, Charge Posting, Payment Posting & AR Follow) to both clients
• One of the directors of the company has a family relationship with the key-man at client’s board.

FTEs- Cost, Pricing & Payment Cycle

• Our per FTE agreed pricings are $2750 for Coding & $1800 for Charge/Payment/AR follow up (other functions)
• The average cost per FTE cost is $972. The calculation includes all overheads and operating monthly expenses.
• The monthly net surplus per FTE will be $880, after deducting average loaded FTE’s cost from Revenue.
• The current requirement of Client-1 is 240 associates including supervisors. The operations will begin with this set-up from January 2012.
• The requirement of Client-2 is 250 associates including supervisors. The commencement of operations for Client-2 will be in 2 phases. 150 associates will go live in January 2012 & 100 associates in February 2012.
• The payment cycle will be of 30-days. The invoice will be raised at end of every month, which will be settled in next 15-days.
• Client-1 has agreed to pay us 62% of the first month’s billing in advance before 5-10 days of the beginning of Operations. Then 2nd month onwards the payment cycle will be regularized as mentioned above.
• Client-2 will pays us advance payment of 150- associates in the month of December 2011. Advance payment facility for 250 associates will continue from February 2012 to June 2012. Thereafter, the payment cycle will be monthly (second half of the month).

The Company

• It has been formed in November 2011.
• At present, there are 4- Directors as mentioned previously ( “Shareholding Pattern”)
• It is a start-up company. Operations will begin from January 2012.
• All contracts will be made with the company registered under Companies Act 1956.
• The company has been formed in state of DE with one member only
• 1st Balance Sheet will be made at the end of FY-2011-12.
• Article of Association is attached, as required.

Current Status

Hiring:

• A Total of 368 associates hired.
• A Total of 20 Supervisors has been hired.

Training: To commence on the December 7, 2011.

Support ( IT )

• 6 E1 lines have been procured with TATA.
• 2MBPS of Internet has been Procured
• PO for EPABX (Siemens Hipath 4000 has been raised to the Vendor
• 300 Systems with 4 Dell servers, Cisco switches have been Procured
• Mail hosting capacity has been exercised with Vendor

Infrastructure:

26,000 Sq. Ft. of Plug and Play area at Rs.45 per Sq. Ft to be leased from the December 5, 2011 (Funds awaited). A Deposit of 2lacs has been paid as advance.

Investors can establish contacts with us on Merar Investment Network.