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19%
Reductions in A/R
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1 Day
Reduced Coding Backlog
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29%
Increase in Collections
Coronis Health Coding Resources Drive Revenue Health Cycle Results
Situation
Growing Coding Errors leading to Stagnant AR
Care Alliance Health Center, a mid-size health center located in Cleveland, Ohio, began their partnership with Coronis Health (FKA PMG, Inc) as a revenue cycle client. Care Alliance is one of six federally qualified health centers (FQHC) we support in Ohio and our third partner working on the OCHIN EPIC installation. Our billing team assumed responsibility for all billing functions post-charge capture, including claim submission, rejection and denial work, payment posting, and overall management of accounts receivable. Coding – and review of coding errors – remained on the task list of the Care Alliance internal staff and providers.
As our partnership developed, the Coronis Health billing team and the internal Care Alliance team noticed a concerning trend. Pending charges requiring a certified coder review were rapidly accumulating, creating a backlog of accounts receivable and putting charges at risk of aging beyond the filing limit. Despite the valiant efforts of the internal staff, the lists continued to grow. The impact ballooned to a high of over 8 days of charges pending by the end of their fiscal year.
Testimonials
“Our internal team was consistently behind on addressing our coding edits due to the sheer volume and the workflow required to address them. The assistance and expertise provided by the Coronis Health coding and billing teams have turned that tide – we were even recognized for our improvement by our system host’s most recent client scorecard!”
Solution
An Expanded Partnership
As we monitored this growing list of pending inventory, the Coronis Health Coding team began to review the type of pending items. We realized our expertise and available resources could efficiently collaborate with our billing team and our partners at Care Alliance to reduce open accounts receivable and increase revenue for these services.
Our coders are experts in the coding nuances relevant to our federally qualified health center (FQHC) partners, encompassing various specialties, including family medicine, behavioral health, dental, obstetrics, podiatry, etc. In collaboration with our billing team and our partners at Care Alliance – we recognized an opportunity to expand our partnership and connect our coding resources. Our coding team immediately dove into the backlogged work queue.
We worked on completing diagnosis edits, modifier additions or corrections, reviewing uncoded notes to determine if a billable service was performed and documented, and offering coding support to the internal team at Care Alliance as needed. We worked closely with Care Alliance to establish a defined workflow to facilitate timely claim resolution to reduce aged accounts receivable, minimize revenue lost due to coding errors and offer provider-specific feedback to help mitigate future returns.
Results
A Healthier Revenue Cycle
The collaboration of the Coronis Health coding and billing staff with our partners at Care Alliance produced significant improvement in the entire revenue cycle. Improved time to pay, increased collections, and reduction in aging are all key indicators of a healthy revenue cycle. Monitoring these – and offering resources and expertise to assist with all aspects of an FQHC revenue cycle – are our keys to success!
Coronis Health assuming management of coding tasks, has also freed internal Care Alliance resources to tackle other priorities within the health center. By delegating coding tasks to our team of certified coders with specific FQHC expertise, Care Alliance staff can focus on other vital tasks necessary to their mission of providing high-quality care to the underserved in Cleveland.
At Coronis Health, our goal is to manage the full scope of our FQHC client’s revenue cycle – from coding and charge capture through payment processing and accounts receivable management. Through a full partnership with Coronis Health, our FQHC clients can reallocate valuable internal resources to manage other clinical and administrative duties critical to the ongoing operation and mission of the health center. Our Ambitious Goal
We started the rebill project with a 90- day timeline, based on the 8 representatives working 35 accounts per day. Our team exceeded that expectation and rebilled all of the claims in 2 months’ time. We averaged close to 55 accounts per day which is a stellar production number. In addition, we also promised an AR Surge to help GRMC get extra money in the door before the end of their fiscal year in June 2021. Our team exceeded the collection goal with a record month! sure where the disconnect could be contact Coronis Health and allow us to do a free financial health check to review your coding, processes, and systems in place to ensure you optimize all aspects.
Don’t be afraid of change because your clinicians are satisfied with their processes, we can work to keep those processes while optimizing your revenue.
Ready At A Moment’s Notice
We were prepared to deploy additional FTE’s and develop a work plan when the facility was overwhelmed and needed help. Because we had a good, cohesive working relationship with the client, we were able to deploy this quickly. They trusted that we would deliver and complete this great undertaking of rebilling over 7,000 claims. The RCM leadership team developed a workflow/handoff diagram reflecting the process of how work is coordinated between the Coronis team and the GRMC team. What made us successful in mitigating the inventory is compiling a full roster of the FTE’s we have assigned to the account. The workflow reflected the owners of each process in our scope of work while outlining the steps involved in the communication process between our team and the GRMC team. This was a true SUCCESS story and Coronis continues to be a great RCM/Coding partner.
-
19%
Reductions in A/R
-
1 Day
Reduced Coding Backlog
-
29%
Increase in Collections
Coronis Health Coding Resources Drive Revenue Health Cycle Results
“We love the challenge of partnering with a rural hospital who is committed to improving operations, clean claim rate and are proud that Coronis has been their RCM vendor of choice since 2019.”
