When you are one of the largest medical billing services companies in the Southwest U.S. and your mission is to help other physician groups solve their staffing and financial challenges, how do you react when you are faced with these very same issues?
You take the advice of the old adage: “physician heal thyself” and call in a professional outsourcing solutions provider who has just the “right medicine.”
A large Texas-based medical billing services company was created in 2004 from the merger of three distinct but complementary founding companies. Two of the companies are experienced and innovative providers of business and practice management services, exclusively dedicated to supporting the needs of primary care and sub-specialty pediatric practices. The third merged company is the largest billing and practice management company in Houston, TX and specializes in hospital-based physician group practices with emphasis on pathology, anesthesiology and radiology.
While these three independent companies had achieved impressive levels of success singularly, the synergy of providing a broader array of services to physicians across the state of Texas was the driving force behind this merger. While this large combined entity with over 700 employees was effectively managing the critical business tasks physicians need to assure maximum returns — giving them more time to focus on patient care, the merger had created some serious challenges.
The newly formed company was struggling with staffing issues. They understood the benefits of outsourcing and knew they needed an outsourced solution to help them with the increased workload, including data entry as well as other critical daily tasks. Also, they were seeking a delivery platform that could help easily manage the workflow and allow present staff to be redeployed to other critical tasks.
Other challenges came from the lack of a document management system (DMS) in place to manage data electronically: data consisted of paper-based claims and EOB’s. Data entry errors were affecting cash flow. The company had to hire extra manpower to manage their old outsourcing partner which drove up the billing services overhead and lowered profitability.
Turnaround time was not acceptable due to delays in coding, incorrect demographic information, slow charge entry, and payment posting.
In order to get the service delivery and profitability back on track, the medical billing company called GeBBS Healthcare Solutions, a New Jersey-based leader in healthcare revenue cycle management (RCM). Through its multiple Global Delivery Centers (GDC) located in India, GeBBS leverages its people, processes, and technology to provide operational and financial solutions for clients.
To address the company’s issues, GeBBS sent a Transition Manager to ensure a seamless implementation for the project and to establish a clear communications channel. The GeBBS’ implementation team also conducted regular web-based training accompanied by conference calls to answer staff member’s questions and manage other training requirements. Then, GeBBS leveraged technology by implementing iP2P ((Intelligent Paper to Payment) solution in order to manage the end-to-end workflow for the billing services company.
iP2P is a full-service outsourced payment posting solution for paper Explanations Of Benefits (EOBs). This solution provides for the automated receipt, processing and posting of all paper payments including insurance payments, patient payments, and correspondence. The iP2P Client Portal provided the company with full visibility into real-time production status, exception management and auditing, along with an image repository for easy retrieval and viewing of EOBs. It allowed the company to revitalize their Accounts Receivable (A/R) by providing immediate electronic access to payment data and images. The iP2P solution integrated with the billing company’s legacy IT hardware and software providing workflow and document management, combined with GeBBS’ highly trained and knowledgeable workforce.
As a result of the “outsourcing medical treatment,” the medical billing services company achieved “financial well-being.” Staffing and outsourcing services have reduced the FTE costs of the company by an impressive 50%. The staffing plan GeBBS designed and implemented ensured a healthy balance between experienced and trained staff (50% of the team was comprised of experienced resources). This was accomplished by the training department organizing a client specific training program. All trainees were carefully evaluated before being deployed on the live project.
In addition, the pass rate for insurance claims has increased to 98%, enhancing revenue flow. A customized document management system, installed at no additional cost, now automates all of the previous paper-based documents for the company, significantly improving their workflow processes. With the scalability provided by GeBBS, the billing services company can now add new physician contracts without adding new FTEs and investing in additional infrastructure. This allows the company to focus on marketing its services to larger physician groups and hospitals and improve their overall corporate profitability.
Outsourcing Benefits at a Glance:
- Reduced FTE costs by 50%
- Increased the pass rate to 98+%
- Created a customized document management system (DMS) at no additional cost
- Provided scalability – company can now add new contracts without investing in new resources and infrastructure and can also focus on marketing its services to larger physician groups and hospitals