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Disaster Averted. Hospital Credit Balances Resolved

Hospital credit balances-min

GeBBS has maintained a team of 150+ experienced analysts specialized in resolving credit balances since 2010 resulting in 30% cost savings.

Client: A large RCM company servicing over 4,400 hospitals and physician groups nationwide.

Challenge

  • Company acquired contract from a hospital, with over $123 million in A/R
  • Over $32 million in credit balances
    • Incorrectly posted payments
    • Patient overpayments of over $3.75 million – Contract manager issues
    • Compliance risk due to credit balances not resolved in a timely manner
  • Credit balance accounts growing at an alarming rate
  • Distorted A/R due to unresolved credits
  • Instant requirement of reducing credits from $32 million to under $15 million

The GeBBS Solution

GeBBS has maintained a team specialized in resolving credit balances since 2010. The team is comprised of highly-qualified individuals with a hospital accounting background and strong analytical skills. As part of the implementation, an experienced GeBBS transition manager was deployed on site to understand the clients existing workflow. A team of 18 FTEs were assigned to analyze the credit balances and identify root causes.

Highlights of the solution include:

  • Detailed study of credit balance accounts and payment posting processes • Review of ERS rules engine on the client’s billing system and process improvements
  • Account balance based resolution strategy implemented
  • Patient credits moved to outstanding patient accounts
  • Incorrect contractual adjustments reversed
  • Unclaimed property worth $4.5 million adjusted within three business days

Results

  • Credit balances reduced from $32 million to $15 million in 45 days
  • Process improvements made to prevent new credits
    • Replacement of contract manager to ensure correct contractual adjustments
    • ERS rules engine updated to prevent automated posting that would create new credits • Further reduction from $15 million to under $6 million in 90 days
  • Old credits over six months resolved on priority
  • Compliance risks mitigated

GeBBS credit balance analysts are among the most experienced revenue cycle consultants in the industry. They undergo a rigorous selection and training process to ensure they can handle complex credit balances cases.

Key Features of GeBBS’ Solutions

  • 150+ experienced credit balance analysts
  • 30% average cost savings of managing credits
  • Secondary billing opportunities
  • Increase compliance
  • Increase profits
  • Scalable: quick ramp up, flexible deployment models
  • Focus on process improvement: prevent new credit balances

Are credit balances impacting your A/R?

Contact Us Today!

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