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SYNERGEN Health Increases average monthly collections of the Large Toxicology Laboratory in Texas by over 115% within the first three months

"As an Oncology practice, it refreshing to work with a company that understood our specific business challenges and provided us with innovative solutions that enabled us to maximize revenue"

Overview

  • Large Toxicology Lab based in Texas
  • Servicing 250+ Ordering clinics & Providers
  • Systems – LIS – Merge. PMS – AdvancedMD (AMD)
  • Over 2,000 samples run / month
  • Over 4,000 claims submitted / month
  • 100% Out of Network Commercial payer billing
  • Avg. Rev / Month - $1.5M

Challenges

  • 90+ Insurance AR > 57%
  • Days in AR of 150 Days
  • >85% of claims billed after 15 Days of sample collection
  • Irregular Coding practices & below-par fee schedule resulting in revenue loss
  • Continuous decreasing trend in Collections
  • Lack of comprehensive patient billing process
  • Lack of proper process on Multiplan & network negotiations
  • Lack of insight into RCM & Operations
  • Unsatisfied Sales team & Referring Physicians

Implementation

  • Implementation of AdvancedMD with DOCTRIX Integration
  • Automated billing process with in-built claims scrubbing rules
  • Custom claim follow-up by payer & submission method with appeals and denial management
  • Revised fee schedule for optimum reimbursement
  • SGH RCM Methodology & Best Practices
  • 48 Hrs. TAT on billing
  • Consistent Patient billing
  • Standardized coding by payer guidelines
  • Streamlining of the negotiation process
  • Weekly KPI Monitoring, Reporting and Meeting
  • Structured management of refunds & over payments
  • Monthly AR walk forward and comprehensive reporting package
  • DOCTRIX Dashboard for complete visibility
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Results

  • Avg. monthly collections increased from $1.5M - $2.3M
  • 60% reduction in 90+ Insurance AR
  • 25% increase in avg. payment per claim - increased from $1,040 to $1,300
  • >98% of Claims entered & Submitted - 24 – 48 hours
  • Minimum AR with risk of Timely Filing
  • Compliant patient billing process
  • Transparency & Visibility into KPI progress
  • Data for Financial decision making
  • Improved/compliant business processes
  • Real-time dashboards and drill down to claim via DOCTRIX
  • Improved satisfaction – Sales team & Referring physician
  • Sustainable growth

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  • health