After several years of losing money based on aging accounts receivables, Dr. Nuzhat Ali, owner of a single provider pediatric practice, was ready for a new revenue cycle management solution.
“I had gone through three billing companies all with poor customer service and poor results. I needed to find a company that was responsive and could help me get my account receivables back on track.”
“I would absolutely recommend this service to other practices. We spent a lot of time with billing vendors who were not providing the services we needed. And now, we are running very smoothly and are in a much better place financially.”
The best part of this new system “Candace and her team, they have been great – reliable, available and accurate!” Dr. Ali said.
Dr. Ali sees an average of 40 patients a day. With such a large volume, she needed an RCM service that would ensure proper code selection and timely follow up on denied claims while maintaining confidentiality of the practice’s financial records.
So, Dr. Ali agreed to meet with Candace Lewis, Director of Revenue Cycle Management (RCM) for Medical Advantage. Dr. Ali had been “burned” before by RCM providers not taking the time to investigate her questions or providing dishonest answers. “When I first met with Candace, I asked her if I would be paid for seeing newborns at the area hospital,” she recalled. “Previous billing vendors had not given me a straight answer to this question. I knew the answer but wanted to hear her response.”
Candace’s response, “I was a little surprised that was her first question, but I was happy to answer, and it gave me insight that she had been given the runaround by other providers in the past.”
Dr. Ali’s said “It was the first time I had ever heard a straight answer to this question. So, I said okay. I will give this new billing vendor a try. I could see she knew what she was talking about.”
Tackling Issues
After performing an assessment, Candace and her team began working on the concerns Dr. Ali had regarding billing and coding. First, they addressed claims rejection. “Our team works through each rejection as it is received,” she explained. “The next step is to determine the reason for the rejection and update the information.”
A main goal: to find the missing information and avoid having to reach out to the practice. “We try not to contact the practice with questions unless it is absolutely necessary,” Candace said.
The second concern was unlimited access to all the practice’s financial information by staff. “Previous companies had no controls in place,” Dr. Ali said. “Staff could login from anywhere at any time.” Candace’s team solution: eClinicalWorks (eCW), the electronic health record (EHR) system used by the practice with RCM processes, offers more controls and security. “We just needed to confirm what Dr. Ali wanted, and we could put it into place,” Candace explained.
Another concern was customer service. “Previous billing companies gave us the runaround with answers to billing and coding questions,” Dr. Ali said. “I wanted a group I could rely on.” Previous vendors had required her office staff and herself to be coders, would provide reports, but not show her staff how to pull their own reports, and more. Candace’s team rapidly developed a reputation to answer questions quickly. “Our highly responsive customer service team makes it a policy to respond within 24 hours to any client question,” Candace said.
“In my opinion, Dr. Ali’s top concerns were the confidentiality of practice financials and the reduction of A/R,” she said. “Our team was able to address these by putting a process in place to ensure month-end reports were concealed so only Dr. Ali could review them and to implement a process where her staff did not have to be so hands-on with the financials and billing operations.”
Results
After working with Candace’s RCM team, Dr. Ali’s practice saw a 50 percent plus increase in revenue. Dr. Ali credits this to timely reporting, accurate coding and claim processing and customer service. By setting up the practice staff to be able to verify deductibles for patients, transition to a new billing and coding system smoothly using eCW and including training and support from Candace and team, Dr. Ali and staff began to operate a more successful practice.
