Reducing turnaround time for reimbursements

CHALLENGES

• Physician used the billing department at the hospital getting insufficient focus
• Inconsistencies in billing process
• Poor quality customer support with practice management system
• Delayed reimbursements for services provided at hospital and at Department of Corrections

PROCESS

• Established a daily billing process at the practice
• Conducted 24-hour clean claim submissions
• Rectified the coding process and alerted physician on denials and accepted coding norms
• Took over benefits verification process
• Negotiated reimbursement rates leading to higher payments
• Setup capitation contract for global payments

RESULTS

• Collections increased by $314,000 after transition
• AR days reduced from 60 to 45 days
• Faster and higher reimbursements from hospital claims
• Transitioned practice to web based practice management system
• Set up propriety analytics portal providing better management control
• Collected old claims worth $45,000 (from IHS) at 100% of charge amount

Improved accuracy of hospital patient data capture and increased annual collections by $314,000