CASE STUDY

BACKGROUND

This medical center in New York is a full-service teaching hospital campus including inpatient care, ambulatory care, long-term care, senior living, and emergency medicine. The hospital implemented athenaCollector, and chose to outsource the athenaCollector co-sourcing tasks to a vendor. However, that vendor was unable to fully deliver on the execution.

CHALLENGES

The hospital found that they were experiencing low collections due to high hold buckets, staffing issues and subpar execution of a number of items in the athenaCollector tablespace.

SOLUTION

They brought in ABW to optimize collections. After working together for a while, ABW assessed that three areas required special focus. ABW found that the medical center was experiencing:

a. increase in claims issues related to credentialing
b. increase in Hold buckets related to claims that were paid but the payments were not posted
c. increase in Patient AR

Working together with the onsite team, ABW developed solutions to address the outstanding issues, including a weekly credentialing report for Medicare, Medicaid and Railroad Medicare, plus a coding project focused on Emergency Department claims. System and process improvements were fully integrated with the team.

RESULTS & BENEFITS

• Increased collections more than 13% in 12 months
• Reduced patient AR by 9% in approximately 2 months
• ABW reconciled and closed over $700,000 in claims that were in hold
• ABW identified providers with credentialing issues and notified staff for resolution
• ABW identified claims with coding issues and provided coding resources
• 35% reduction in claims in Hold status due to coding errors

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.