Overview
- A healthcare firm in California was facing significant revenue losses due to high claim denial rates.
- OutsourceRCM provided a solution through denial data analysis, corrective actions, AR prioritization, and advanced training.
- The result was a substantial reduction in denial rates, timely collections, and a significant increase in revenues within six months.
The Story of our Customer
- Our client is a leading healthcare revenue cycle management firm based in California, established in 2007. They specialize in claim submissions, payment tracking, denial management, and financial analysis.
- High claim denials resulted in significant revenue losses, negatively affecting the client's financial health.
- The client turned to OutsourceRCM for a solution to reduce denial occurrences and improve accounts receivable collections.
The challenge faced by our Customer
The client faced a substantial revenue loss due to many claim denials, adversely affecting their financial stability. Recognizing the situation's urgency, the client sought a robust and effective solution to address the high denial rates.
- Revenue Loss Mitigation: The client faced substantial revenue leakage due to frequent claim denials, resulting in significant financial strain.
- Financial Impact: The denials negatively affected the client's financial health and balance sheet.
- Seeking Effective Solution: To address this challenge, the client sought a robust and proactive solution to minimize denial occurrences and enhance collections from accounts receivable.
The Solution
In response to the substantial revenue loss caused by frequent claim denials, our tailored approach focused on mitigating denial instances and enhancing accounts receivable collections efficiency for the client.
- Analyzed three months of denial data using root cause analysis to identify issues.
- Studied denials and errors to suggest corrective actions.
- Prioritized AR by age bucket to address severity.
- Implemented trend identification for bulk denials' resolution.
- Provided advanced training for efficient error detection and correction.
The Result
Our solution yielded the following outcomes for the client:
- Denial rate reduced by 30% within the first three months, followed by an additional 80% reduction in the subsequent three months.
- Significant reduction in denial backlog every month, ultimately achieving complete clearance.
- Timely collection of all claims ensured improved revenue streams. Notable cost savings leading to a remarkable 40% increase in revenues within just six months of implementation
Elevate Customer Service with OutsourceRCM
OutsourceRCM is a top-tier BPO company offering global expertise from 5 delivery centers. Our inclusive services range from inbound support to outbound call solutions, delivering comprehensive resources for enhanced scalability.
For a reliable, profitable healthcare BPO partner, contact us today.
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