Our Client Results / Billing & RCM
Medical Advantage Solves Multi-State Pediatric Therapy Group Accounts Receivable Issues
Results
Optimized
70+
payers’ fee schedules in the practice management system
Enrolled
100
payers with the clearinghouse with electronic claims submission enabled and ERAs and EFTs set up
Over
1,000,000
In AR rebilled and collected over two years
Overview
A multi-location pediatric therapy group specializes in special education, home–based, and early intervention services. Their comprehensive and collaborative approach to therapeutic care for children has resulted in high retention rates as patients thrive in home, school, and community environments.
Challenges
The pediatric group approached Medical Advantage for front EHR optimization with the goal of maximizing reimbursement. An EHR that runs smoothly, converts providers correctly, and ensures authorizations was the top priority. During the optimization process, the following issues were revealed.
Inflated fee schedule
Unclean claims being billed out incorrectly
Untapped reimbursement opportunity
Our Solutions
Our consultants applied their rich healthcare background, including experience in typical operations such as billing, to develop a more stable RCM structure for the client.
Refiled claims
Improved authorization process
Corrected fee schedule
Improved AR projection accuracy
Discovered and activated denial management tool available to client but being unused
Set up ERAs/EFTs with insurance payer
Medical Advantage Can Help
Medical Advantage is an innovator in healthcare. Our years of experience, data driven strategies and in person approach drive change, improve outcomes, and maximize ROI. Our team has the expertise to provide customized, actionable solutions to decrease the cost of care and improve quality for your practice.
