Every medical practitioner wants to provide patients the best possible care. However, the complexities in healthcare revenue cycle management make this more challenging. Factors such as increased paperwork, accounts receivable (AR) management, lower insurance reimbursements, and denial of claims, all add up to a substantial overhead. Its repercussions can adversely affect cash flow and force physicians to close down their private practices. Tranquilmoney, a technology company headquartered in New Jersey, combines technology and innovation to offer healthcare revenue cycle management services through its suite of solutions. The company brings to the table software solutions for revenue cycle management, EHR handling, and medical billing.

In an interview with MD Tech Review, Dr. Karun Philip, the Chairman, CEO, and co-founder of Tranquilmoney, shared his company's journey and how their solutions mitigate various disruptions in medical practice management. Dr. Philip has an MS and Ph.D. in Computer Engineering and Biomedical Engineering from the University of Iowa, and a BE in Electrical Engineering from Birla Institute of Technology and Science, Pilani, India. His Ph.D. in intelligent character recognition using neural networks is the core of Tranquilmoney’s revenue cycle management software.

Could you give us a quick snapshot of the company’s history and its evolution over the years?

We initially launched our software in 1995 when Citibank hired Tranquilmoney. They wanted to move their loan processing to their own offices in India, Sri Lanka, and the Philippines from European branches. But later, in 1998, we were hired to rescue a healthcare receivables financing operation run by Prudential Securities. The client company approached us to reprocess their data and recover the missing funds, which amounted to more than $150 billion. From this experience, we decided to focus on managing the healthcare revenue cycle. In this process, the cash flow from third-party payers were often disrupted due to the lack of accurate information to follow up. Over the years, Tranquilmoney has provisioned practice management software and fully certified EHR capabilities to physician’s practices along with medical billing and revenue cycle management.

With the increased complexity in running the business of medicine, many physician practices are looking to sell or even close down. We collaborate with such physicians and keep them abreast of the changes that are happening. This enables physicians to stay ahead of the competition and continue their practice.

Today, what do you think are some of the most significant pain points in the revenue cycle management arena?

The most significant pain point for revenue cycle management professionals is the enormous stacks of paper-based documents used in third-party billing and collection. Tranquilmoney helps move the data to an electronic platform while continuing to accept any quantity of paper data.

We use this paper data for double-entry and verification. Claim denial or partial payment of claims by third-party payers is a critical issue for hospital groups. Tranquilmoney has a seasoned team of professionals who are experienced in claims research. They follow up the entire medical billing revenue cycle and ensure timely and complete payments. On average, we have increased claims recovery by over 20 percent, while our total charges are less than five percent.

What are some of the current technological trends existing in the health care management arena, and how do you implement the same in your offerings?

There are many ways in which Medicare is experimenting with reimbursement methodologies. These methodologies have undergone dynamic disruptions over the years. Tranquilmoney simplifies the processes for healthcare providers by being a seamless interface to such disruptions. Amidst all these changes, we charge a standard amount that remains the same regardless of the updates we provide.

Tranquilmoney's solution for pharmacy receivables management is PharmTracker. The technology supports our receivables and reconciliation management services for Pharmacy chains, grocery store chains, mass merchant chains, and independent pharmacies. As a web-based solution, the product addresses various aspects of receivables management such as reconciliation of checks with corresponding payment, application of payments to claims, exception processing, and reporting compliance with laws, among others.

We have a certified EHR solution PracticeTracker for physicians receivable management that can be integrated with practice management systems for all medical specialties, including workers' compensation. The solution includes features such as a scheduler, inbuilt custom reports, charts modules, dashboards, integrated fax options, secured messaging, patient portals, attorney portals, address validation, audit and contract management, clinical and billing alerts, secured access with IP restriction, and more.

Could you give me some technical details about your products?

I have a Ph.D. in the field of intelligent character recognition using neural networks, which forms the crux of our technology. However, I understood that character recognition supported by AI doesn’t give 100 percent results. When it comes to recognizing characters for financial transactions, accuracy is a key consideration. For that reason, we decided to employ human labor for paper to electronic data conversion. Eventually, we developed the software to control the workflow and gave the workforce a structured work process to follow. We started with paper intensive processes and helped the pharmacy system move to digital systems. We took the same technology for addressing the challenges physicians face while performing paper intense tasks. We use the data from paper and convert that into a proprietary format and then to Health Level 7, which is the industry standard.

We have a formal training program that enables individuals to work for the doctor to code in each specialty. Our product also performs the set of standard functions like online appointment scheduling for doctors, templates to help them diagnose and, and decide what procedures to follow.

As insurance companies have the option to change the contract without informing the physician, our software can capture and report that event to the physician. This creates chances to renegotiate the plan and create the documentation you need for the same. We provide the software for free, and we charge a percentage of the claim, depending on the state or federal rules. We get paid only a small percentage of what the physician receives from the insurance companies. The charge varies greatly depending on factors like the specialty, and the number of claims, to name some.

Could you elaborate more on the security measures you adopt to ensure the safety of data.

We are an SSAE type II certified company and adhere to HIPAA compliance practices. Additionally, we have put in place proper internal controls and processes to deliver high-quality services to its clients. Tranquilmoney is a certified EHR solution provider, and we have gone through a rigorous evaluation process to receive that status. Our servers are hosted with a professional hosting platform, and we implement a 128-bit security level. Clients can access our solutions on any browser, but there are options to limit access to specific IP addresses.