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1,800
Insurance Payers Reviewed for Mapping
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8
Months of Decreasing AR
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2X
Revenue in 8 Months
How We Helped A Group of Hospitalists Increase Their Revenue and Decrease Their Rejections
The Problem Before Us
A group of hospitalists who are responsible for acute and post-acute care of patients was struggling with a broad range of issues. The complex type of billing, contracting issues, coding issues, Practice Management System mapping issues, and the use of many different EHR systems posed challenges for them. Previous RCM companies tried to unravel their complexities but never truly discovered the root causes of the issues at hand, which, in turn, resulted in only more complexities for the next billing company that would take on this challenge.
Due to these failed attempts, the group experienced a large loss in revenue and a backlog of AR that left them feeling as if no one could help.
Testimonial
“A February 2022 visit showed the need for payer mapping. Coronis reviewed and mapped 1,800 different insurances and clarified eligibility payer IDs. This immediately caused a drastic drop in the rate of rejections. Over an 8-month period, Coronis not only increased the volume of encounters being billed monthly but also doubled overall net revenue.”
Coronis Steps In
Coronis Health was contacted by the group in an attempt to find someone to help them stop the downward spiral of revenue. Coronis deployed a team onsite to meet with the client within 72 hours of that call.
On October 13, 2021, Coronis started the process of unraveling the many years of failed attempts and complex dynamics of this client, and the decision was made to accept this challenge, knowing it was not going to be easy. Coronis went to work, deploying their top team to make sure this would succeed. This team of experts included Implementation Directors, Analysts, Client Service Directors, Directors of Systems, and Account Managers.
Digging Deep
In the discovery process, Coronis had identified the need for a Practice Management System change, which also required a clearinghouse change. This came as a very heavy lift, as the client was already facing a steadily dropping revenue. This would require data mapping, enrollments, and system setup to be seamlessly completed without causing more spiraling of revenue. By November 15, 2021, the client was officially moved to the new practice management system, and Coronis had started the process of recovery for the hospitalists.
The challenges did not end there. This change allowed Coronis time to begin a deeper dive into the current contracts, EHR system challenges, coding issues, and clean-up of accounts receivable in the previous management system to try and salvage some of the lost revenue for the client.
By mid-January, revenue was no longer declining. Processes were being implemented, mapping of data fine-tuned, and a true partnership was being built.
A Partnership Was Formed
In February 2022, the Coronis team deployed again to work with the group–this time in pursuit of reaching a stable state of revenue. Coronis and the client met for three days, covering everything from reporting issues and errors to insurance mapping and future expectations. Both parties left the three days of meetings with assignments and goals that needed completion within the next sixty days. Coronis and the client worked diligently together, building the partnership, fine-tuning processes, and cleaning up data mapping.
The Test of Time
April 2022 was the date set in February to return to the client’s facility to see if their goals were met. As they prepared for their return, Coronis found that they had reached a steady revenue state by March 2022 month end.
Coronis Health and the group of hospitalists worked together, built a solid partnership, and ultimately succeeded. The journey is not over, as Coronis continues to improve processes, increase revenue, and implement additional affiliates that need this level of expertise and commitment to succeed.
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1,800
Insurance Payers Reviewed for Mapping
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8
Months of Decreasing AR
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2X
Revenue in 8 Months
