The COVID pandemic created challenges for practices that had to pivot their operations to restore revenues, adapt to the changing environment, and accelerate growth.
This webinar, brought medical billing experts from Coronis Health together to discuss best practices for improved financials and provide case studies on how practices have improved operations. In this final part of a 3-part series, we share specific information and case studies highlighting efficiency maximization.
Peter Drucker had a quote: “Efficiency is doing better what is already being done.” Any vision of operations can greatly impact the success of your practice, and even though the work is being completed and money is coming in the door, we don’t just stop there. We aim to fully utilize systems and staff by continuously reviewing processes, workflows, and the potential automation of manual procedures.
Maximizing Efficiency Case Studies
Maximizing efficiency for our clients is all about looking at what processes are being performed manually, and how we can utilize systems that are already in place – enabling them to work smarter, not harder.
An FQHC came to us with an extremely manual Medicare PPS billing process. Medicare PPS billing in the FQHC world is tricky because it involves split billing. Our client had staff members dedicated to manually reviewing each and every Medicare charge, and this client had a very high proportion of Medicare patients. The process was time-consuming, complex, and susceptible to errors. Changing the system was also risky –what if the system breaks and the staff forgets how to do it manually?
We forced the issue of utilizing the existing system, maximizing that functionality and taking advantage of what was available in their host system. We also minimized risk by collaborating with the client, system host, and RCM team to create an environment of transparency where we all had the same end goal. We improved compliance, while reducing charge lag and average days to pay.
- Eliminated the need to manually review all charges and append billing codes prior to claim submission
- Ensured accurate billing without relying on human judgment – instead, the system applied the rules
- Reduced manual payment and adjustment posting, while focusing on working denials
The next case study features a large multi-specialty provider office with 10+ locations and 60+ providers. With the staff operating autonomously, this created inconsistency in their processes across the board. Having multiple specialties and locations only added to the complexity of this practice’s billing process.
These factors led to issues such as disparity in how they resolved denied claims or how they collected front desk payments, as well as no transparency within the organization to review their overall fiscal health. In effect, they were unable to make decisions in a timely manner or identify which processes were causing issues.
They were also utilizing multiple systems that weren’t streamlined, resulting in manual labor. The client was also concerned about outsourcing their billing, thinking that they might lose control or wouldn’t have the transparency that they believed they had.
We did a task analysis and identified the clearinghouse inefficiencies which were causing the significant work loss and the inability to achieve transparency. We partnered with them to develop new, coherent processes across all of their locations, as well as unify all of their operations.
- Eliminated redundant work by updating their PM system and clearinghouse
- Created bi-directional claim stream allowing for quicker identification of front-end rejections and claim resubmission
- Provided access to claim analytics, including denial and rejection trends.
Our third case study on maximizing efficiency consists of an urgent care facility that had financials in the red and billing in complete crisis. During the pandemic, this client was performing thousands of COVID testing with telehealth visits and had a backlog of over 250,000 claims. The client grew rapidly due to the ability to perform COVID testing, but did not have the back office set-up and tools in place to manage this large influx.
We were able to clear the backlog by using technology to automate charge pass-through from the LIS, combined with our offshore team working 24 hours a day, 5 days a week, a dedicated onshore onboarding team, and a focused onshore revenue cycle team with certified professional coders that specialize in coding and billing for COVID vaccinations, testing, and telehealth visits.
After providing an in-depth task analysis of the patient registration process, we identified that by leveraging technology, the client’s backlog could be caught up in 30 days.
- After just the first week working with this new client, Coronis Health received the following thank you letter:
“I am truly grateful for your daily updates, and it helps put my mind at ease that Coronis Health sincerely cares about our organization. Because of the confidence Coronis Health has given me, I gave out some well-earned bonuses this week to some of the most dedicated and hardest working people I know. It felt really good to do that.”
Are you losing revenue due to inefficient operations? Let us help you maximize your efficiency and boost your revenue cycle. Contact us today to learn more.