Case Studies

ICD-10 transition by OutsourceRCM boosts client's revenue by 40% with seamless implementation

Overview

  • Our Florida-based client, established in 2005, specializes in medical billing services for over 40 specialties across 20+ U.S. hospitals.
  • They sought our help for an upcoming ICD-10 transition due to their lack of coding expertise and preparedness.
  • We provided intensive ICD-9 and ICD-10 training, using a rigorous approach with weekly audits to ensure a successful transition.

Story of the client

  • The client is a Florida-based medical billing firm established in 2005, providing services to over 40 specialties across 20+ U.S. hospitals, but faced challenges with the impending ICD-10 changes due to a lack of coding expertise.
  • Despite their experience in medical billing and revenue cycle management, they sought our help for a smooth ICD-10 transition.
  • Our assistance led to a successful transition, improving accuracy, reducing costs, and increasing revenues by 40% within six months.

The Challenge

The client encountered substantial challenges as they aimed to transition smoothly to the ICD-10 coding system.

  • The first challenge was ensuring client readiness for the ICD-10 transition within the grace period.
  • The second was uncertainty over the plan's effectiveness in real-world implementation.
  • The third was inspiring coders to commit to training while also reducing the learning curve to meet the deadline.

The Solution

  • The team ensured an early and solid preparation for the ICD-10 transition, assembling a team of expert trainers with deep knowledge of ICD-9 and ICD-10.
  • Customized training sessions and General Equivalence Mapping were implemented to enhance learning and familiarity with new codes, while external contract coders were hired to maintain focus.
  • Rigorous weekly audits were conducted to track issues, implement corrective measures, and provide education based on feedback, ensuring accuracy and managing changes effectively.

The Result

Our tailored solution brought significant benefits to the client

  • Seamless Transition: Effortlessly adopted the new coding system while meeting quality standards.
  • Enhanced Accuracy: Achieved through smooth ICD-10 conversion, reflecting improved precision.
  • Substantial Savings: The transition led to notable cost reductions and operational efficiencies.
  • 40% Revenue Increase: Within the first six months of implementation, revenues surged by 40%.

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Case Study