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.
Streamlining RCM to eliminate denials and maximize revenue:
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 illustrates the tangible financial and operational impact of an integrated RCM strategy. By standardizing processes, leveraging technology, and deploying expert teams, we helped our client unlock sustainable revenue growth and operational efficiency. Our partnership with this client underscores how a proactive and strategic approach to revenue cycle management can drive long-term success for healthcare organizations navigating expansion and acquisition challenges.