SYNERGEN Health Increases City Doc Revenue by 11% within 120 Days

Difficulty in managing growing volume, 90+ Insurance AR over 35%, provider credentialing delays and errors, delays in claim submission and taking a longer time to close a month were few Challenges CityDoc faced before they met our RCM specialists.

Overview

• Urgent Care center
• 5 Facilities operated in different locations in TX
• Multiple providers at different levels (MD, DO, NP, FNP, PA) -83% of them are credentialed with Medicare at least for one location
• Highest revenue generating months: December/January

Implementation

• Systems review and optimal configuration
• Implementation of Denial Management
• 21-30 day collection follow up cycles
• Root cause analysis & preventive actions
• E&M codes analysis
• Daily claims submission
• Weekly reconciliation of Deposits
• Best Practices recommendations training
• Standard policies & Procedures for RCM
• Weekly & monthly reports
• Doctrix dashboard for reporting
• Identify & reporting workflow opportunities of front desk staff & providers

Challenges

• Resources contrarians to do adequate follow up
• Insurance AR in 90+ at over 35%
• Over 8 days taken to close month
• Provider credentialing delays and errors
• Lack of transparency to Practice performance
• Delayed claim submission
• Difficulty in managing a growing volume
• ICD-10, PQRS & Meaningful Use

Results

• 90+ AR reduced by 95% from S111K in 2014 to S6K at present
• Avg. Revenue/Claim increased by 11% (from S133- $148)
• >95% claims submitted within 24 hours from DOS
• First time payment rate of 98%
• Days in AR reduced by 53% (from 32 days to 15 days)
• Best in class & compliant business processes
• 100% transparency into RCM processes
• Close of month reduced to 3 business days