Overview
ABC is a United States healthcare organization specializing in efficiently managing hospital visits and patient care. They were seeking assistance in transitioning their data from SRS software to NexTech. They also wanted to improve their healthcare back-office processes, medical billing and coding, denial analysis, and appointment setting.
OutsourceRCM was brought in to help with these challenges. We managed their claims, tracked statuses, handled rejections, improved back-office processes, and enhanced patient experience through efficient data collection and appointment setting.
The Story of our Client
ABC is one of the largest independent healthcare organizations in the U.S., excelling in managing hospital visits and patient care with advanced techniques. They provide a wide range of healthcare services, including comprehensive treatments and patient care.
ABC needed assistance in these core areas to improve operational efficiency and profitability:
- Medical billing
- AR specialist services
- Denial analysis
- Appointment setting
The Challenge
The client needed more skilled in-house resources to manage healthcare back-office processes efficiently. They were facing potential issues in organization related to accuracy and timeliness. Medical billing and coding procedures lacked precision and efficiency, leading to claim denials and financial discrepancies.
Additionally, the client needed help scheduling and managing patient appointments, causing potential patient dissatisfaction and operational inefficiencies.
The Solution
At OutsourceRCM, we introduced our comprehensive healthcare management solutions, which were designed to optimize patient appointment settings, streamline medical billing processes, and conduct thorough denial analyses in the following way:
- Our team underwent extensive medical terminology and concepts training, ensuring a deep understanding of the field and accurate interpretation of medical records. We used Nextech EHR software to prep the encounters, which was key in streamlining the data transition process.
- We also conducted regular training sessions for the client's staff, focusing on areas that required improvement or industry updates. This enhanced coding quality and streamlined data transition from SRS software to NexTech.
The Result
Our collaboration with ABC, a major U.S. healthcare organization, significantly improved their back-office processes and profitability. Here are the key outcomes:
- Implementation of rigorous medical coding audits and denial analysis led to a 25% increase in collections within the first few months.
- Denial rates were reduced from 17% to 7%.
- Our comprehensive approach to healthcare back-office processes streamlined claim submission, payment posting, and appointment setting.
- The patient experience was enhanced, leading to increased satisfaction.
- Profitability was boosted by 40% due to the improved efficiency in back-office processes.
- The potential net collections rate increased to 90% or higher.
Conclusion
OutsourceRCM is a leading business process outsourcing firm with five global centers. We offer a range of services, including inbound support and outbound call center solutions. Our approach combines human expertise, technology, infrastructure support, and quality assurance to enhance your business operations.
Contact us today if you are looking for a dependable, lucrative, and synergistic healthcare BPO partner to reach your goals. Our positive client testimonials and long-lasting relationships reflect our track record, establishing us as a dependable and client-focused service provider.
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