Case Study
CDM standardization provides defensible charge practices and revenue neutrality during a multi-facility system conversion
CDM standardization provides defensible charge practices and revenue neutrality during a multi-facility system conversion. Case Study CDM standardization provides defensible charge practices and revenue neutrality during a multi-facility system conversion. IDN client with $15B+ NPR needed to transition 88 facilities with disparate chargemasters to Epic, a radically different structure, over a three-year time frame. Download…
“Auditing the auditor” uncovers a need for revenue cycle education and process improvement
“Auditing the auditor” uncovers a need for coding education and process improvement. Case Study “Auditing the auditor” uncovers a need for revenue cycle education and process improvement. A Midwest IDN client with 1,200 beds and $1.8B NPR was experiencing decreased coding accuracy and productivity, negatively impacting financial performance. Reliance on internal QA processes and a…
Partner leverages coding partnership expertise to mitigate compliance risk
Partner leverages coding partnership expertise to mitigate compliance risk. Case Study Partner leverages medical coding partnership expertise to mitigate compliance risk. A routine third-party audit reported high ER Evaluation & Management (E/M) error rates for an acute care hospital with 182 beds and $313M NPR. Incorrect reporting of these errors would skew current revenue and…
Client reduces AR days by 36% in 120 days
Client reduces AR days by 36% in 120 days. Case Study Client reduces AR days by 36% in 120 days. This 47-bed acute care hospital battled delayed reimbursement and missed revenue due to coding accuracy and productivity. They saw an increase of coding-related denials and lower-than-anticipated reimbursement levels. Coders had limited access to training resources…
Acute care facility leverages expert resources to successfully appeal clinical denials
Acute care facility leverages expert resources to successfully appeal clinical denials. Case Study Acute care facility leverages expert resources to successfully appeal clinical denials. A 200-bed, $509M NPR client lacked resources able to review and resolve their large volume of denials, nor did they possess the skill set to determine plausibility of certain clinical appeals.…
Safety net system transforms denial backlog into $20M+ gain
Safety net system transforms denial backlog into $20M+ gain. Case Study Safety net system transforms denial backlog into $20M+ gain. This 800-bed, $532M NPR safety net system struggled with retaining the resources needed to address an immense denial backlog and lacked visibility into their root causes. This threatened cash collections and financial viability of the…
High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%
High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%. Case Study High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%. BrightSpring, a complex care provider who assists clients residing in intermediate care facilities and/or receiving home-based services, saw a climbing number of ineligible Medicaid clients. This forced the client to write…
Non-profit system uses Epic optimization to improve enrollment process for patient eligibility
Non-profit system uses Epic optimization to improve enrollment process for patient eligibility. Case Study Non-profit system uses Epic optimization to improve enrollment process for patient eligibility. Jefferson Health, 607-bed, three hospital system experienced patient interview delays, slowed account conversion and increased risk of error when attempting to secure coverage for under and uninsured patients. Eligibility…
Medicaid eligibility conversion and collections improved by optimizing enrollment processes
Medicaid eligibility conversion and collections improved by optimizing enrollment processes. Case Study Medicaid eligibility conversion and collections improved by optimizing enrollment processes. For this academic health system of 1,104 beds and $1.8B NPR, Medicaid eligibility processes were highly manual and workflow had not been assessed since their Epic transition. This resulted in fewer conversions, less…
Outsourcing partnership transforms HIM-related KPIs and reduces DNFC by 83%
Outsourcing partnership transforms HIM-relatedKPIs and reduces DNFC by 83%. Case Study Outsourcing partnership transforms HIM-related KPIs and reduces DNFC by 83%. What problems can revenue cycle management outsourcing solve? This 478-bed health system struggled with essential HIM performance metrics. The department had a sustained record completion backlog, ongoing troubles with coding quality and production, as…
- « Previous
- 1
- 2
- 3
- Next »