Services Deployed
Revenue Cycle Management Consulting
Overview
SCALE was engaged by our Client to improve their overall performance in RCM and:
- Assist in interviewing Director and manager of RCM
- Make recommendations on policy changes/adds
- Assist in updating RCM procedures and processes
- Assist in updating RCM procedures and processes
- Update/ Implement workflow process
- Increase the overall RCM performance
- Draft SOP’s
- Deliver industry standard KPI’s
Execution
- SCALE was engaged to assess and make recommendations on ways to improve the overall performance of our Client’s RCM team, and evaluate Allscripts performance in lifting or elevating the Client’s overall financial situation
- We reviewed policies as they related to the RCM department, overall operations of the department, and their impact on the financial deliverables
- Eligibility
- Payment posting – performed by Allscripts
- SCALE utilized a practical and collaborative approach with the CFO/Director and support personnel to develop and expand the overall performance of the RCM department, using data to drive changes to processes and grade performance of RCM and Allscript team members
- Denials management
- Coding
Results
SCALE developed the following KPI’s, setting and meeting industry standard goals for our Client:
- Coders 98% accuracy
- Denials Management: No more than 15% AR in >90 day bucket
- AR follow-up specialists: resolving payable claims within 35-45 days
- Medical records turnaround within 30 days
- Developed SOP’s
- Decreased claim lag time to 6 days
- Decrease AR >90 day buckets to less than 20% overall outstanding debt
- Front end coding accuracy at 62% vs 27% at start