Introduction
An integrated healthcare system based out of Dallas, Texas approached Billing Paradise recently to resolve its outstanding AR and coding backlogs. The health care system had state of the art facilities and offered personalized patient experiences through multiple primary care locations.
They owned and managed comprehensive spine, orthopedic and pain management clinics; sports medicine and physical therapy centers; bariatric and general surgery institutes; digestive management clinics; diagnostic imaging center and licensed acute-care surgical hospital.
About the client
| Details | Values |
|---|---|
| Provider PT | 86 |
| Charge Lag Average | 20 |
| Charges per Year | 54M |
| Charges per Month Average | 4.5M |
| Average Claims transmit per Month | 4000 |
| Average Claims transmitted < 48 Hours | 70% |
| Outstanding AR | 16M |
A Technology Enabled AR Recovery Solution to Resolve Aged and Ongoing AR
BillingParadise helps healthcare organizations to quicken long term cash recovery. We fill the gaps in the existing AR cycle of our clients and draw upon decades of experience in AR management to offer best-of-class AR recovery services.
“Every time we try to reduce AR backlogs we hit a blank wall. It is difficult to clear backlogs and handle current AR issues as well. We are desperately looking for AR resolution support to liquidate all that revenue stuck in AR buckets”, said Glen Matheson, the revenue cycle director of the healthcare system.
Located in Plano, Texas, this multispecialty provider group was facing an uphill battle with their outstanding AR of 16 million dollars & 10 million of the AR was in the 120+ days bucket, almost half of the receivables were uncollectable. They were also facing backlogs in their coding processes, which was increasing steadily. The man-agement team realized that the losses to their current cashflow will have a long-term, detrimental impact on their revenue cycle in the long run.
A Wind down of the Healthcare System’s Accounts Receivables
Glen Matheson sought proposals from several third party organizations. According to the revenue cycle director, they decided to team up with BillingParadise due to their expertise in handling similar projects and opera -tional efficiency. AR Analyzer, the AR management software developed by BillingParadise was another major factor behind the healthcare system’s decision to work with us.
Solutions Spotlight:
- AR wind down services for payer and patient AR
- LRRA audit to spot deficiencies
- Preserve AR asset value
- Swift AR resolution
To bring their outstanding AR to current, BillingParadise conducted an extensive Lost Revenue Recovery Audit (LRRA) and made a series of recommendations in key areas to bring coding and the outstanding AR to current.
The goal was clearly to define a path of recovery of their old AR and also assist in coding the pending claims that arose due to the backlog.
It was mission critical to strengthen the AR foundations of the healthcare organization.
The First Steps
Once the recommendations were made, Billingparadise then developed a series of plans to work along with the revenue cycle team of the health system to bring the AR& coding to current.
The initial step was to identify the AR that fell into the collectable bucket. This was arrived at based on various permutation and combination of parameters that considered the filing & appeal limit of insurances and correlated the same with their outstanding AR.
The second step was sort the collectable work order in such a way that it addresses the immediate priority claims and makes sure that none of the claims moves into uncollectable buckets and shows immediate recovery. The third step was to review the uncollectable AR and seek a viable point of contact in the insurance and see if we can bring some recovery on the bulk claims lying with them.
The third step was to review the uncollectable AR and seek a viable point of contact in the insurance and see if we can bring some recovery on the bulk claims lying with them
AR Analyzer, the proprietary AR management software built by BillingParadise decreases the time and costs involved in AR management. It automatically isolates high risk receivables. As the AR data is categorized according to the financial risk involved it streamlines and quickens the AR follow-up process.
Our AR resolution experts worked on the key risk segments. AR Analyzer’s prescriptive work listing engine allocated work to receivables management teams based on their experience in handling similar AR issues. Through a thorough analysis of the healthcare system’s AR information, our AR resolution team was able to spot several overlooked pockets of revenue.
Critical AR issues were bubbled up by the system and resolved. Our 24/7 AR follow up services enabled the healthcare organization to recover revenue lost due to inefficient and poorly monitored AR processes.
Testimonial
AR resolution is a convoluted process. We were staring at huge losses before BillingParadise stepped in. The outside perspective certainly helped. For an AR portfolio as complex as ours, we are glad that we took the right decision and teamed up with the right organization.
- Glen Matheson, revenue cycle director
