Our client, one of the nation’s top medical billing companies, provides revenue cycle solutions to hospitals and physician groups across the country. As one of their hospital clients faced increased days in AR, high denial rates, and increased A/R in the 120+ day aging bucket, Access Healthcare implemented an iterative program to improve metrics quickly and shift focus to denial prevention. Please read the case study for solution details.
A large, durable medical equipment (DME) billing software company was looking to expand its revenue cycle management business aggressively. They knew their in-house team and manual processes would not be able to scale and would impact their profit margins. They began to search for an outsourced vendor to partner with and allocate portions of their revenue cycle management. It was imperative that the outsourced vendor be able to handle and scale with the company’s aggressive growth plan and not impact delivery for their current customers.
Backlogs are common in many steps along the revenue cycle. Whether they result from a surge of patient encounters, a lack of resources, or inefficiencies in the process, the result can be debilitating to medical practice. Charge backlogs delay claim submissions which lead to delayed reimbursement, which can skew revenue reports. In addition, delayed claims can result in timely filing denials, which cannot be appealed successfully.
Accounts Receivable backlog is not uncommon, particularly in consideration of the ever-increasing complexities of Revenue Cycle Management. While somewhat understandable, the negative impact on the business can be severe. Not only does overall financial health suffer, but for both billing companies and healthcare systems, reputations and the opportunity for growth will be compromised.
Our client, a leading national provider of information solutions and revenue cycle management services in the outpatient space, faced a substantial loss of revenue stemming from workflow-related problems with their offshore revenue cycle partner. Management of the workflow was inconsistent with little communication between departments. "Things" were falling through the cracks, most notably, revenue. As the software provider looked to rebuild its value proposition, improving customer satisfaction was a priority, its leadership team asked Access Healthcare to resolve these issues.
