CASE STUDIES
We Get You Results.
CASE STUDY #1
Clinical Documentation Improvement
Situation >
A community hospital was struggling with a high volume of LOCUM providers, low query response rates, and accurate CC/MCC capture.
Solution >
Partnered with CDI Department Leadership & Physician Leadership
Updated queries and escalation procedures to accurately and comprehensively “tell the story” of the patient’s condition and the services provided
Provided targeted physician education in areas of high complexity and/or confusion
Result
8.8% INCREASE
in Medical CMI
6.5% INCREASE
in CC/MCC capture rates
CASE STUDY #2
Charge Capture & Denials
Situation >
Large children’s hospital system seeking specific improvement in charge capture and denials processing
Additionally hoping to improve system automation and utilization
Solution >
Redesigned denial and charging workflows
Implemented automated system actions for denials routing and prioritization
Implemented system rules to capture frequently missed charges
Result
$16M IMPACT
of charge capture on Net Revenue
$2M IMPACT
in Denial Workflow improvements & efficiencies
CASE STUDY #3
Full Revenue Cycle Approach to Net Revenue
Situation >
Leadership desire to prepare the organization for planned future scale and growth.
Solution >
Performed an 8-week Revenue Continuum Diagnostic Review, identifying a minimum of $10M of opportunity across the Revenue Cycle
Partnered with Revenue Cycle leaders to launch improvement efforts across Patient Financial Experience, Revenue Integrity, Avoidable Write-Offs, Clinical Documentation, and more
Engaged with Clinical Departments, Utilization Management, Managed Care, IT and more to further collaborate on net revenue opportunities
Result
$16.6M IMPROVEMENT
in Annual Net Revenue
30% IMPROVEMENT
in Patient Payment Collections
CASE STUDY #4
Perioperative Services
Situation >
Perioperative Services leadership expressed concern that revenue did not align with the resource consumption and complexity of services in their area.
Solution >
Conducted an analysis of charging and services across the OR, Anesthesia, and PACU
Partnered with Perioperative Services and Revenue Integrity leadership to redefine charging methodology
Aligned charging methodology to resource consumption and cost drivers across all services
Automated charging with the EHR based on the new methodology and clinical documentation
Result
$11M IMPROVEMENT
in Annual Net Revenue
CASE STUDY #5
Pre-Service Focus
Situation >
A five-hospital system wishing to establish a pre-service center
Goals to improve patient experience and reduce front-end related denial write-offs
Solution >
Standardized pre-registration, upfront collection, and ABN processes across 120 departments
Implemented a new, centralized pre-registration team
Result
$23M REDUCTION
in Denial Write-Offs
60% IMPROVEMENT
in Upfront POS Collections
CASE STUDY #6
Practice Management
Situation >
Health system rapidly growing through physician practice acquisition
Challenges with inconsistent process and lack of reporting
Solution >
Refined standard reporting across all areas
Created a denial management program
Developed a comprehensive staff and management training and QA program
Result
4.1% INCREASE
in Cash Posted
82% REDUCTION
in Provider Enrollment Write-Offs
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