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Revenue Cycle Transformation increases revenue by 8% while reducing days in AR by one half

Facing challenges with high insurance and patient aged receivables along with total days in AR at 137, a remote cardiac monitoring company servicing over 1,000 clinics turned to SYNERGEN Health for revenue cycle management transformation.

Overview

  • Remote Cardiac Monitoring service provider based in California and Texas
  • Servicing over 1000 ordering clinics and providers
  • Over 5000 event monitoring cases per month
  • Over 6500 claims submitted / month
  • In-network and out of network payors
  • Internal central billing office
  • Monthly revenue at $3M

Challenges

  • 90+ Insurance AR > 71% and 90+ Patient AR > 84%
  • Days in AR >137 Days
  • First time payment rate < 55%
  • Revenue losses due to delays in securing patient consent letter
  • Revenue losses due to delay in securing medical records from referring providers
  • Out of network payors sending payments directly to patients

Implementation

  • Reconfigured billing system for optimized collections
  • Revised charge master
  • Re-engineering patient billing and collections process
  • Implemented DOCTRIX® Analytics and dashboards
  • Implemented weekly KPI monitoring and reporting
  • Converted payments and EOBs to electronic format
  • Optimized denials and appeals management
  • Implemented monthly root cause analysis and transformation
  • Help complete non-credentialed payors
.

Results

  • 8% increase in overall revenue
  • Days in AR reduced to 68 days
  • First time payment rate > 62%
  • 154% increase in patient collections
  • Direct pay patient payment collections >80%
  • 80% to 100% increase in large commercial payor payments
  • Over 98% of claims reviewed within 48 hours
  • Secured successful outcomes on major denials

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