After only two years, net collections drastically increased, and accounts receivable payments started coming in faster.
Greenspring Surgery Center (Greenspring) is an accredited, state-of-the-art surgical facility that handles outpatient gastrointestinal and orthopedic surgeries and procedures. The goal at Greenspring is to provide convenient and comfortable care for all patients.
While their patient care is superior, Greenspring had complicated work to complete before admission and after discharge. Missing information and incorrectly coded procedures can result in frustration for both the patient and the center. Even great surgery centers need coding, billing, and revenue cycle management support sometimes.
Pain Points & Challenges
Back in 2016, the medical billing team at Greenspring found themselves in a complex position. They needed help shortening the time it was taking to collect insurance payments. In addition, their accounts receivable (A/R) reached an all-time high. They were helping many people, but for a variety of reasons ranging from lack of authorization to incorrect codes, surgery bills weren't getting paid. There were also significant contract variances between their center and insurance companies.
After evaluating their situation and exploring options, they decided to hire our team at in2itive Business Solutions. They believed that our services and expertise could set their course straight.
What in2itive Did to Help
When Greenspring brought our team on board, we provided a client manager, certified professional coders, billing specialists, A/R specialists, patient account representatives (PAR), and a revenue cycle specialist. Each team member worked to identify issues and weaknesses, offer recommendations, and in many cases, implement change, all to ensure that Greenspring’s business could operate efficiently and maximize revenue.
As a team, we looked at Greenspring as an integrated whole. We relied on their internal team of medical billers and coders to help us grasp the full picture. Getting a better understanding of our client's situation from top to bottom helps us to identify where our services are needed.
Some of the services we provided included:
- Cleaning up credit balances (patient and insurance)
- Understanding payer contracts
- Collecting correct operatives and documentation
- Looking at a patient’s whole story beyond codes and operative notes to provide the best recommendations to the billing staff and doctors even if it meant creating addendums to documentation
- Identifying emerging insurance verification trends
- Holding patients to the correct self-pay level
- Developing and implementing efficient workers’ compensation strategies
- Creating processes to eliminate chances of missing data or upfront information
Our team of specialists also handled details like catching incorrect billing codes, discovering contract differences, and fixing patient records to reflect insurance updates. Working alongside the center’s staff created a team atmosphere and equal partnership that led to great results.
Results
After two years of working with Greenspring to get processes and procedures in place such as implementing PARs, setting up payment plans, improving billing and coding efficiency, and educating staff on verification estimates, they made the improvements needed to reach and maintain their goals of quality patient care and convenience while strengthening their bottom line.
- YTD net collections skyrocketed to 111%.
- Aging of 61+ days decreased by 19%.
- Decreased number of no-authorization denials received.
- Self-pay A/R decreased by 70%.
- Payment per case increased by 15%.
- Newly developed processes lead to claims being reimbursed promptly and efficiently.
It takes a team to make the appropriate changes needed to improve and grow. Our mission at in2itive is to support and enable great medical facilities to focus on their goal of excellent patient care and customer service. We are committed to providing exceptional billing services, revenue management, and claims processing.
