Leveraging advanced technology and expert teams, Access Healthcare delivered measurable results for a multi-state physician group
Growth is vital for healthcare organizations across the US. Our client, a physician group that serves patients in more than 20 states, pursued a strategy of growth through acquisitions. However, integrating varying revenue cycle management (RCM) systems and technology posed a significant challenge.
Our client requested an audit of its revenue cycle operations and asked us to devise a plan to address significant denial issues. In response, we created a comprehensive approach that included standardizing processes and technology, addressing clinical denials, and improving collections. We assembled an experienced acquisition transition team, including clinical coders, denial management experts, and operations leaders.
We deployed our team and technology to improve the overall clean claim rate, A/R days and RCM productivity. Our innovative approach involved identifying root causes, communicating with the client teams, and resolving revenue cycle denial issues by:
Analyzing the A/R and denials data using advanced technology
Handling outstanding denials and implemented an automated workflow process to prevent recurring denials
Focusing on improving clean claim rate
Access Healthcare significantly improved RCM process by:
Establishing a framework to exceed monthly targeted collections
Reducing 120+ days A/R to less than 20%, stabilizing at 14%
Decreasing 90+ days A/R by $15 million
Reducing total number of A/R days from 51+ days to 43 days in year one, and further to 41 days from year two onwards
Increased insurance collections by $2.8 million per month for an annual boost of over $33 million
Our successful transformation demonstrates the power of an integrated RCM approach in addressing the challenges faced by growing US healthcare organizations.