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