A renowned Behavioral and Rehab center in Florida was hit buy severe cash crunch, the revenue cycle systems and processes were outdated and ineffective.Workforce with the needed expertise and knowledge gap were issues across the revenue cycle.
Challenges faced by the client:
A dedicated team from Atlantic RCM reviewed the entire process flow and identified the following challenges that was causing the reduced cash inflow.
- Eligibility Benefits Verification System was a manual process since it was time consuming the benefits were not verified most of the time
- Prior Authorization not obtained
- Delay in submitting claims electronically
- Clearing House and Payer Rejections not fixed
- Rendering Provider not being credentialed with many Insurances
Atlantic RCM’s Solution:
Atlantic RCM developed a customized revenue cycle process flow, our goal was to implement this process that will address all the challenges and help increase the cash flow
- Automation for Benefits Verification: – We provided access to front office with one click access across 1000+ payers to verify benefits in real time
- Prior Authorization: Services requiring Prior Authorization were identified and the process to obtain Prior Auth was implemented before submitting the claim to the payer
- Timely Claim Submission: All approved claims were checked and submitted to the payer within 24 hours
- Rejections: Submitted claims were monitored daily for an acceptance report from the Clearing House and Payer, claims that were rejected were checked for deficiencies and resubmitted
- Credentialing Provider: Payer specific credentialing for each provider was identified and the credentialing process was initiated
Result Achieved by Healthcare Center:
With the customized revenue cycle process that addressed all the issues we were able to improve the collections, reduce denials and improve the patient experience
- Average monthly collection increased by 50%
- Average denials decreased from 842 to 427
- Submission of Clean claim increased from 65% to 96%
- Rejected claims fixed and resubmitted increased from 32% to 100%
Atlantic RCM is one of the leading multi-specialty medical billing companies in USA that serves 25+ major medical billing specialties. Our experts work across your practice in billing, collections and account receivables management, to help you succeed.
Get in touch with the leading medical billing outsourcing company to learn more. Call us at (786) 264-1222 or write to us Info@atlanticrcm.com