A Federally Qualified Community Health Center in Boston was experiencing difficulty in its billing department. Denials were rising, cash flow was up and down and staff turnover was increasing. What was the true problem, and could it be fixed?
In late 2002, Peter Gerondeau was appointed the senior vice president of finance & administration at Dimock Community Health Center (CHC) in Boston. After completing his initial round of staff meetings, he compiled a list of concerns. Heading the list was the billing department. Gerondeau’s over 20 years of experience in nonprofit health care was steeped with billing department and IT challenges. But while facing an issue in the billing department was no surprise, the pervasiveness of this problem was most unsettling.
In late 2002, Peter Gerondeau was appointed the senior vice president of finance & administration at Dimock Community Health Center (CHC) in Boston. After completing his initial round of staff meetings, he compiled a list of concerns. Heading the list was the billing department. Gerondeau’s over 20 years of experience in nonprofit health care was steeped with billing department and IT challenges. But while facing an issue in the billing department was no surprise, the pervasiveness of this problem was most unsettling.
Dimock has deep roots in the community. Since its founding in 1968, the CHC has offered a myriad of services designed to support the health care needs of the community and its patients. Dimock’s core competency is delivering health care services to its patients regardless of their ability to pay. It is the mission of the organization and its lifeblood.
But to continue funding and offering these vital services while growing its expanding health care offerings (e.g., primary care, OB-GYN, behavioral health, pediatrics, eye and dental), Gerondeau needed consistent cash flow. The billing department was trying its best to process encounters into claims and subsequently into revenue for the CHC.
However, Days in A/R were climbing, denial rates were rising and, inexplicably, encounter forms were being lost at an alarming rate. Gerondeau had two options: Restructure the billing department or look for other solutions. He called a series of senior staff meetings to study the issue and determine next steps. Around this time, PMG came onto the scene. The firm is a national leader in providing billing, A/R management services and UDS reporting to CHCs nationally. After a comprehensive vetting process, Dimock signed and started with PMG in 2004.
“Initially PMG conducted an operational assessment focusing on the encounter form process and workflow. Then, all of our providers were trained on coding, compliance and documentation. Finally, we went live with PMG billing. In the last four years, PMG has doubled collections, eliminated lost encounters, offered monthly billing denial reports and kept cash flow steady”, said Peter Gerondeau of Dimock. “In fact, the Dimock auditors cannot believe our Days in A/R are fewer than 40. We are now able to focus on patient care, which is our core competency and mission.
When staffed in-house, the billing department never received priority attention and results suffered as a result. PMG understands what makes CHCs unique, and its staff communicates issues before they become problems.”
According to UDS Reports, Dimock generated over 75,000 unique patient encounters in 2010.
About PMG
PMG is an industry-leading Revenue Cycle Management company offering services to Federally Qualified Community Health Centers and look-alike organizations since 2000. The company speaks the CHC language (e.g., UDS reports, cost-based reimbursement, sliding fee scales, etc.) and has dramatically increased revenues, with flat patient growth, at each of its CHC clients. For more information please visit www.gopmg.com or call Robert Skeffington at 401-616-2000 x 108.