CASE STUDY

BACKGROUND

This orthopedics practice focuses on providing patients with personalized and continuous care across physician, therapist, and patient communication, for example co-locating their PT department within the clinic. From vocational rehabilitation to stem cell therapy, the center provides a wide range of patient services and, consequently, payers.

CHALLENGES

The practice experienced many difficulties in transitioning from a legacy billing system to an integrated approach. This was manifested by constant billing staff turnover (five people in two years), as well as other staffers wearing “too many hats” such as surgical staff working billing claims, and administrative staff working hold buckets. Denials were not handled in a timely manner and this led to write offs. The industry transition to high deductible plans, plus increasing self-pays, resulted in unsustainable patient AR levels.

SOLUTION

The practice brought in ABW to augment the CBO with a focus on consulting and financial reporting, as well as to undertake a clean-up project. ABW worked all the hold buckets, which helped the practice to increase overall revenue. In addition, ABW contributed their workflow improvements in areas such as workers compensation so that claims are followed up in a timely manner.

RESULTS & BENEFITS

• MGRHOLD bucket – reduced 5 percentage points
• HOLD bucket – reduced 7 percentage points
• Days in AR (DAR) – from 43.2 to 33.7 days
• Payments total per month – improve by 16%

ABW has helped more than 5,000 providers across 45 states through its mission to create more revenue, time and peace of mind for providers, staff, owners and patients.