Revenue Cycle Performance Improvement case study.

The Challenge
Despite being financially successful, a large, hospital-affiliated group practice was leaving millions of dollars uncollected every year. Upon review, it was estimated that the practice was writing off approximately $2,000,000 a year as a result of untimely filing deadlines and improper submission of claims. More than 35% of the dollars outstanding were at least 120 days past due, and the practice was taking an average of 60 days to post charges.

The Solution
The following is a selection of the many initiatives that were utilized to improve the financial and operational performance of the practice:

• Recruited an additional 2.0 billing FTE and reorganized billing department location to accommodate additional staff and influx of volume
• Redesigned all front desk operations and implemented protocols for collecting all patient demographics and appropriate fees: self pays, co-pays, deductibles (if applicable), non-covered services and patient balances
• Implemented systems to post charges and file claims daily
• Redesigned accounts receivable management systems
• Implemented systems to correct all rejected EOBs (explanation of benefits) within 72 hours
• Created and implemented a skills assessment test for billing department personnel as part of a performance appraisal initiative

The Results
During a twelve month revenue cycle performance improvement engagement, Advantage achieved the following results:

• Increased total charges 44%
• Increased annualized net collected revenue more than $4,000,000
• Increased patient volume more than 25%
• Decreased accounts receivable more than 38%