Local Physicians And A Nonprofit

Case Study: Case Study: Regent Revenue Cycle Management solutions put joint ventures on solid financial footing

SITUATION

In 2011, Regent entered into joint ventures with local physicians and a nonprofit, acute-care hospital to launch two ambulatory surgery centers, a specialty outpatient facility and an ASC that offered a broad range of ENT, general surgery, orthopedics, podiatry, ophthalmology and urology services.

Soon after both ASCs began seeing patients, the facilities began exploring enhanced revenue cycle management options with Regent to maximize cash flow and outsource the critical areas of claims filing, documentation, accounts receivable and coding.

SOLUTION

Collaborating with its joint venture partners, Regent performed a comprehensive needs assessment to determine the right RCM solutions for the ASCs. This included exploring new options for improving and restructuring the centers’ cash flow and business model, as well as developing and refining the following areas:

Core RCM functions: An extended revenue cycle can place considerable strain on an ASC’s ability to stay in business. Regent recommended a new model that included utilizing its expertise in the areas of billing, payment posting, and insurance and patient follow-up

Coding and dictation: Looming ICD-10 implementation, training and compliance is forcing many healthcare providers to rethink their coding strategies. Regent suggested partnering with third-party coding and dictation specialists to process all of the ASC’s cases

Patient Financing: Cost-sharing efforts mean many insured patients are now responsible for a significant share of their medical costs. Regent recommended a turnkey financing option designed to reduce collections, increase patient satisfaction and improve cash flow. Regent also proposed a training program for staff on effective financial counseling and follow-up techniques

Management Information System: The centers were using disparate Management Information Systems (MIS)
which were outdated, inefficient and had limited reporting capabilities. Regent recommended upgrading to a robust MIS designed strictly for ASCs

RESULTS

The ASCs adopted Regent’s recommended RCM solutions in March 2012, and the positive results were almost immediate.

The new management information system easily interfaced to other systems, increased efficiency and made reporting critical ASC metrics effortless. The new coding and dictation procedures also freed up valuable time for the ASCs’ staff

to focus on their primary job responsibilities. Highlights of Regent’s work also included:

Accounts receivable: Regent’s streamlined AR processes significantly increased cash flow. Within one year, Regent reduced the days in AR from 55.6 days to 31.4 days. Both centers also are now able to collect approximately 80 percent of their claims within the first 90 days

Community relations: Both ASCs operate in a small community. Regent’s recommended training program overcame significant staff concerns over a more proactive approach to billing, collections and obtaining advance payments from patients, many of whom staff members know personally

Claims appeals: Regent proposed a systematic approach to appealing denied and underpaid claims from payers. The new procedure increased overall revenue by 19 percent during the first 12 months after it was enacted.