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

You go to bat for your patients. We go to bat for you.

Illuminating your path to financial excellence through strategic insights, data-driven solutions, and fierce determination.​