Facing challenges with high insurance and patient aged receivables along with total days in AR at 137, a remote cardiac monitoring company servicing over 1,000 clinics turned to SYNERGEN Health for revenue cycle management transformation.
Case Studies
Revenue Cycle Transformation increases revenue by 50% while reducing days in AR by half
Overview
- Remote Cardiac Monitoring service provider based in California and Texas
- Servicing over 1000 ordering clinics and providers
- Over 5,000 event monitoring cases per month
- Over 6,500 claims submitted / month
- In-network and out-of-network payors
- Internal central billing office
- Monthly revenue at $3M
Implementation
- Reconfigured billing system for optimized collections
- Revised charge master
- Re-engineering patient billing and collections process
- Implemented DOCTRIX® Analytics and dashboards
- Implemented weekly KPI monitoring and reporting
- Converted payments and EOBs to electronic format
- Optimized denials and appeals management
- Implemented monthly root cause analysis and transformation
- Help complete non-credentialed payors
Challenges
- 90+ Insurance AR > 71% and 90+ Patient AR > 84%
- Days in AR >137 Days
- First time payment rate < 55%
- Revenue losses due to delays in securing patient consent letter
- Revenue losses due to delay in securing medical records from referring providers
- Out of network payors sending payments directly to patients
Results
- 50% increase in overall revenue
- Days in AR reduced to 68 days
- First time payment rate > 62%
- 154% increase in patient collections
- Direct pay patient payment collections >80%
- 80% to 100% increase in large commercial payor payments
- Over 98% of claims reviewed within 48 hours
- Secured successful outcomes on major denials
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