How Access Healthcare provided tech-driven processes, a governance structure, and knowledge management strategies to achieve results
Since 2021, one of the largest providers of revenue cycle services to hospitals and healthcare systems has partnered with Access Healthcare to enhance its coding operations. The client requires multi-specialty acute coding, professional coding, revenue integrity, coding audits, and coding denial management.
Addressing key operational challenges
At the outset of the partnership, it was critical to demonstrate Access Healthcare’s ability to execute a large-scale coding transition. This meant proving Access Healthcare could hire, train, and deploy certified coders at scale while customizing transition and service delivery processes for each new physician practice and hospital client. Access Healthcare also needed to clear a backlog of high-dollar claims approaching timely filing limits while consistently exceeding production and quality service levels.
Keeping training teams updated with evolving business rules and standard operating procedures (SOPs) was essential across the diverse client base. To achieve this, Access Healthcare leveraged its proprietary knowledge management tool to not only streamline the hiring and training process but to also provide real-time reporting and compliance dashboards. Access Healthcare’s technology ensured that every new coder and operational process seamlessly aligned with our partner’s high expectations.
Finally, Access Healthcare created a transparent and collaborative governance model to ensure seamless integration and ongoing operational success
Implementing a game-changing strategy
To achieve a seamless transition and sustain growth, Access Healthcare initiated the following strategies:
Deep dive into client priorities: Conducted in-depth due diligence with key stakeholders to assess existing workflows and pain points.
Tailored transition plan: Developed a customized plan with attainable timelines to meet various service level agreements (SLAs), eliminate backlogs, and improve compliance.
Standardization of policies and procedures: Established SOPs tailored for each client and specialty, ensuring a structured and consistent coding approach.
Enhanced reporting and governance: Implemented Access Healthcare’s knowledge management system to provide a multi-tier governance model with real-time daily, weekly, and monthly performance reports covering production, audit coverage, inventory status, and staffing, which improved decision-making and compliance.
Integrated technology solutions: Deployed our proprietary knowledge management platform to streamline coder recruitment, training, and ongoing performance monitoring. This technology centralized SOPs, maintained continuous updates to business rules, and provided robust reporting capabilities.
Streamlined new client onboarding: Mirrored the client’s RCM service provider structure to streamline transitions and efficiently clear inherited backlogs.
Collaborative, ongoing learning and training: Shared training resources with the client’s team and refined processes based on continuous feedback.
Delivering impactful results
Access Healthcare established reliability, scalability, and operational excellence by implementing several key initiatives including:
Leveraging our workforce optimization and automated training technologies to rapidly scale from 0 to more than 500 certified coders to support both front-end and back-end coding functions, ensuring consistent operational efficiency and quality across both coding functions.
Surpassing the SLA of 95 percent accuracy with an outstanding average accuracy of 98.62 percent.
Using our advanced analytics and our integrated knowledge management platform to monitor performance and drive ongoing operational enhancements.
Seamless onboarding of new hospitals and physician practices.
A robust governance model ensuring continuous improvement and operational efficiency.
Boosting confidence in offshore coding quality and talent.
A new benchmark in outsourced excellence
By overcoming the initial doubts about outsourcing, Access Healthcare exceeded client expectations and redefined operational excellence in medical coding. Our innovative, technology-driven approach transformed preliminary uncertainty about outsourcing into a trusted partnership, delivering a scalable coding operation that to this day, continuously evolves to meet the needs of this client’s hospitals and physician practices.