Client Background and Context
- One of the nation’s largest hospital group, with more than 150 acute care centers, behavioral health facilities & ambulatory centers having 3 central business offices (CBOs). Client was –
- Looking for extended business partner to manage their AR > 30 Days, Denial Management and Secondary Billing
- Looking to streamline front office and business office functions, and implement workflow tools and best practices to improve collections rate
Solution
- Implemented proprietary tool iAR to build resolution strategy and dedicated team for backlogged denials (TFL/AFL – tollgates were implemented)
- CARC and RARC Analysis for frequently denied claims and implemented Coding Helpdesk
- Deployed 250 in-house FTEs including subject matter experts
Impact delivered – Performance
- 28 days improvement in overall DSO from 58 to 30 days
- 5 days TAT achieved for all denials (14 -> 5 days)
- 12% Reduction in front office and billing office denials (19% -> 7%)
Impact delivered – Financial
- 15% Uptick in collections within 6 months of Go Live ($72 M -> $81 M)
