Client Background and Context
- Leading provider of healthcare business & operational services serving 600 hospitals, 2,400 physician practices 37 million patients; with annual collection of $41 billion. Client was facing –
- Increasing backlog and coverage issues over weekends / holidays
- Increasing quality issues leading to revenue leakage across IP & OP
- Ramp up challenges to achieve 5.2 M charts per year
- Looking for a partner to address these challenges while minimizing existing vendor base
Solution
- Comprehensive CAC deployed with detailed reports to monitor accuracy & productivity
- 500+ in-house certified FTE coding talent with decision tree matrix, EM calculator & diagnosis based miss out audits
- Scalability through HIM training to physician coders & experienced resource hiring from market
Impact delivered – Performance
- 65%. reduction in DNFB (7+ -> 2.5 days)
- 70% reduction in missed procedures (10% -> 3%)
- 75% reduction in EM levelling issues (12% -> 3%)
Impact delivered – Financial
- $1M incremental cashflow per month
- 40% additional revenue capture ($0.65 M -> $0.9 M)
