Case Studies

OutsourceRCM Boost Profitability by 40% through Streamlining Neurosurgical Group's Back-Office Operations

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Overview

Our client is one of the U.S.'s largest independent neurosurgical groups, specializes in minimally invasive treatments for complex back, neck, brain, and neurovascular conditions, providing a variety of neurosurgical services.

The client needed assistance with managing their healthcare back-office processes, medical billing and coding, denial analysis, and appointment setting, hence they approached OutsourceRCM

OutsourceRCM managed claims, tracked statuses, handled rejections, improved back-office processes, and enhanced patient experience through efficient data collection and appointment setting.

The Story of our Customer

  • Our Client is one of the largest independent neurosurgical groups in the U.S., excels in treating complex adult neurovascular conditions with advanced, minimally invasive techniques. They provide a wide range of neurosurgical services, specializing in conditions of the brain, spine, neck, and neurovascular system.
  • The client needed assistance with healthcare back-office processes, including medical billing, AR Specialist services, denial analysis.
  • OutsourceRCM significantly improved the client’s back-office operations, reducing A/R days from 74 to 38, increasing collections by 25%, and achieving a 40% savings to boost profitability.

The challenge faced by our Customer

The client needed more efficient invoicing and essential documentation for insurance claims. We suggested robust billing methods with precise documentation to ensure prompt payment, reduce admin workload, and adhere to rules. Without these, financial challenges arose. The goal was to speed up projects and boost cost-effectiveness, refocusing on better patient care.

Key challenges identified:
  • The client was struggling with efficient management of healthcare back-office processes, with potential issues in organization, accuracy, and timeliness.
  • Medical billing and coding procedures were lacking in precision and efficiency, leading to claim denials and financial discrepancies.
  • The client had difficulties in effectively scheduling and managing patient appointments, causing potential patient dissatisfaction and operational inefficiencies.

The Solution

  • MedBilling proudly introduced its comprehensive healthcare management solutions, which were designed to optimize patient appointment setting, streamline medical billing processes, and conduct thorough denial analysis. This resulted in improved financial health and a better patient experience for the Client.
  • They ensured seamless patient appointment setting, efficient medical billing, and thorough denial analysis, which led to improved financial health and a better patient experience for the Client.
  • We also conducted regular training sessions for the client's staff, focusing on areas that required improvement or industry updates. This resulted in enhanced coding quality and streamlined healthcare processes.

The Result

The implementation of OutsourceRCM' healthcare services led to significant improvements in medical billing and appointment management, resulting in increased efficiency and patient satisfaction.

  • The meticulous application of medical coding audits and denial analysis resulted in a 25% increase in collections within the first few months and a reduction in denial rates from 17% to 7%.
  • Our comprehensive approach to healthcare back-office processes, including claim submission, payment posting, and appointment setting, resulted in a smoother patient experience, a 40% increase in profitability, and a potential net collections rate of 90% or higher.

Leverage OutsourceRCM to Serve the Customers Better

OutsourceRCM is a leading business process outsourcing firm with five global centers. We offer a range of services including inbound support and outbound call center solutions. Our approach combines human expertise, technology, infrastructure support and quality assurance to enhance your business operations.

If you seek a dependable, lucrative and synergistic healthcare BPO partner to reach your goals, you can contact us promptly.