Client
Our client is an analytics-driven company and a world-class service provider. It provides revenue cycle services, processing millions of transactions every day for 86+ hospitals across 15 states in the United States.
Challenge
For a major player in the field of hospital billing, optimizing Accounts Receivable (AR) follow-up and collections is imperative to ensure financial stability.
Our client faced several critical challenges in AR that necessitated a strategic transformation:
- Low Balance AR Follow-up for Hospitals: The client grappled with effectively managing low balance AR follow-up for hospitals, leading to a growing backlog.
- Complex AR Follow-up for Physician Services: With little experience in physician billing services, the client had to navigate complex AR follow-up for physician services.
- High Volume of Account Closures and Clerical Requests: A substantial workload was attributed to account closures and clerical requests, adding to the operational strain.
What the client wanted:
- Handle AR Follow-up for Providers: Given the client’s limited experience in physician billing, the primary focus was on AR follow-up for providers.
- Resolve Backlog: The aim was to resolve the backlog of AR follow-up effectively and efficiently.
- Reduce AR Balances in >180+ Days Bucket: The client expected a substantial reduction in AR balances in the >180+ days bucket within a short three-month period.
- Go live faster: There was a pressing need for rapid implementation setup and a quicker go-live ramp-up of AR operations.
Solution
To address these challenges, Hexaware used technologies, such as a fully automated AR management tool, issue log tracker, and document repository to devise a multifaceted solution:
- AR Segmentation: AR was segregated into aged and new categories, allowing for the mapping of reimbursement timelines and the identification of trends with various carriers.
- Specialized Knowledge Pool: A specialized knowledge pool was created to focus on AR follow-up for claims older than 90 days.
- Analysis: An in-depth analysis of customer and denial reasons was conducted to enhance efficiency.
- Implementation Plan: A comprehensive implementation plan, spanning one week of planning and technical setup, along with two weeks of knowledge transfer and training, was designed.
- Pilot Run: A one-week pilot run was executed with rigorous output analysis and feedback incorporation, leading to a successful go-live.
Benefits
The implementation of this strategic approach led to substantial benefits for the client:
- DSO Reduced by 50% in 4 months
- Financial stability improved by 50%
- Collections on AR balances older than 180 days consistently increased by 6% monthly
- Productivity increased by 175%
- Identifying trends and patterns reduced call volumes by 60%
The robust transition methodology ensured a seamless transition and go-live process, minimizing disruptions.
Summary
A major hospital billing firm, grappling with low AR follow-up, sought transformation. Through AR segmentation, specialized knowledge pools, and innovative technology, DSO was slashed by 50% in under four months, with monthly collections surging by 6%. Enhanced productivity and efficient trend identification further boosted the revenue cycle, highlighting the power of strategic planning and technology in healthcare financial management.
