Exact Sciences Corp., a prominent molecular diagnostics company known for its revolutionary product, Cologuard, sought to streamline its order entry process to enhance efficiency and reduce operational backlogs. Access Healthcare was chosen to implement a robust order entry system, aligning with Exact Sciences’ vision of delivering seamless and timely patient care
Exact Sciences Corp. is a leading molecular diagnostics company known for its groundbreaking product, Cologuard, which transformed colorectal cancer screening. As the company expanded its product offerings, it encountered significant challenges, including escalating administrative expenses and mounting A/R backlogs due to a high volume of unresolved claims.
In the vast realm of molecular diagnostics, Exact Sciences Corp. shines as a trailblazer in the early detection of cancers. With a primary focus on preventing colorectal cancer, the company made headlines in 2014 with the groundbreaking launch of Cologuard, the world’s first stool DNA test for this fatal disease.
One of the largest providers of revenue cycle services to hospitals and healthcare systems contracted with Access Healthcare Services for inpatient DRG Coding, Inpatient CDI services, and DRG Validation from 2021. As a first step, while embarking on the transition of IP DRG coding & CDI processes to our global delivery locations, Access Healthcare established a multi-level governance and transition team. This team included the Client’s HIM leaders, facility-specific hospital staff/ HIIM team members, Access Healthcare’s team of medical coders, and clinical documentation specialists.
One of the largest providers of revenue cycle services to hospitals and healthcare systems contracted with Access Healthcare Services for delivering multi-specialty acute coding, professional coding, revenue integrity, coding audits, and coding denial management since early 2021. This case study describes how Access Healthcare enabled the customer to grow its coding operation from 0 to 500 coders.
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.
As a fast-growing national chain of oncology centers with operations in over 20 states sought to accelerate growth through acquisitions, they were looking to address significant revenue cycle denials issues even as they integrated the acquired practices.
In 2019, they turned to Access Healthcare to transform their revenue cycle operations by standardizing processes across the revenue cycle, addressing clinical denials, and improving collections. We utilized a seasoned revenue cycle team, including a strong transition team, clinical coders, denial management experts, and operations leaders to shift focus from denial management to prevention.
With millions of healthcare payment transactions to be reconciled with the respective charges on their system, our client, one of the largest cloud-based revenue cycle and EMR software providers, required a scalable solution. Access Healthcare’s echopay delivers over 99% accuracy while improving productivity by 2.5X
Our client, a nationwide medical billing and software company for anesthesia practices, had challenges when it came to billing volumes and AR recovery. By adapting our best practices from years of experience, along with our quality-centric services and efficiency, we were able to overcome a surge in claims and cashflow errors in a complex payor mix with our insurance verification solution.
In today’s healthcare landscape, the need to do more with less has never been greater. Those companies providing services to the healthcare industry are being asked to streamline processes and increase efficiency at every step. Sometimes this results in a breakdown of quality and trust. Even a company that places a very high value on the quality of their services and maintaining a positive relationship with their customers may not keep up with the rapidly growing demands of the industry and are forced to outsource part of their business. Unfortunately, sometimes those partners don’t have the same values.
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.
Outsourcing medical coding has become a common practice among healthcare providers and medical billing companies. The ability to scale effectively, provide a highly educated workforce and a dedicated team of coders has led to cost savings and more efficient processes. However, many companies still struggle with finding the right, trusted partner for this critical discipline of revenue cycle management.
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.
