CASE STUDY

Full-Service Billing

Overview

SCALE began working with a multi-specialty practice with approximately forty providers on a host of performance improvement initiatives.

The practice decided that it had insufficient leadership and expertise to improve and turn around its billing operation and so it engaged SCALE to provide all RCM services. In a matter of weeks, SCALE took over the billing function and began improving performance.

SCALE RCM brings decades of experience building and managing revenue cycle operations of scale.  We have developed and refined best practice systems and processes through billing across more than 30 medical specialties as well as numerous sites-of-service and practice management & EHR systems.

Execution

SCALE successfully took on RCM for a multi-specialty practice with minimal disruption and improved performance in a matter of weeks.

STEP 1:

Preparation

Confirm transition to new billing software

Submit proposal to Client

Onsite visit to Client

Access to Hospital EMR, Lockbox, Clearninghouse

STEP 2:

EMR & IT

Launch new practice management software

Enroll in Clearinghouse

Confirm transition of hospital practice management software

STEP 3:

Billing

SCALE began billing for all new claims

STEP 4:

Take Over Centralized Eligibility

Complete transition of handling eligibility

STEP 5:

Old AR Transition

SCALE to begin old AR project, through completion

Results

Tight Collection Cycle

Days to bill improved by 68% and days in AR improved by 39% despite complication of transitioning billing systems

Days to pay improved by 58% and AR greater than 90 days improved by 47%

Five months in, SCALE achieved a tight, industry best practice collection cycle, improving unfulfilled encounters by 68% with the only outstanding claims represented by patient responsibility and claims that were denied or underpaid and needed to be appealed

Improved Internal Coordination

Better coordination with internal operations team and less distraction

Practice Performance Improvement

Centralizing eligibility has eased onsite burden and resulted in improved performance

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