Access Healthcare's Best Practices and Methodologies  make Short Work of 65,000 Charge Entry Transactions Backlog


PERSPECTIVE

Backlogs are common in many steps along the revenue cycle. Whether they result from a surge of patient encounters, a lack of resources, or inefficiencies in process, the result can be debilitating to a medical practice. Charge backlogs delay claim submissions which lead to delayed reimbursement, which can skew revenue reports. In addition, delayed claims can result in timely filing denials, which cannot be appealed successfully.

 

SITUATION

A regional medical billing company experienced explosive growth with multiple physician practices, all of which carried significant charge backlogs. In addition, these physician offices used outdated, niche billing management systems that did not adhere to a best practice workflow, thereby reducing efficiency. The billing company faced a looming challenge: each day that passed represented a loss in revenue for their physician customers. Yet, without adequate staffing resources or the right project management plan, the challenge would only grow well beyond the 65,000 charges already in backlog. 

 

OBJECTIVEs

Minimize charge backlog as quickly and efficiently as possible to avoid further loss in revenue.

 

SOLUTION

Access Healthcare was engaged to eliminate the charge backlog as well as provide ongoing services for the billing company. After just 1 hour of training on the billing systems used by the practices, Access Healthcare applied best practice methodology to create a scalable model for minimizing the backlog quickly and efficiently. Access Healthcare’s workflow management tool, arc.flow, and unique queuing methodology were employed to allocate work based on the staff profile. The management system also provided complete transparency to the customer enabling them to track the progress. Within 90 days, the backlog was reduced to 5,000 charges, thereby stabilizing current volume for the billing company.

With the flexibility to manage many unique situations, the methodology and technology to increase efficiency in the right areas, and the people to effectively scale for large projects, Access Healthcare was able to address the billing company’s major pain points including:

  • Lack of resources: Access Healthcare immediately allocated 9 qualified, full-time employees to resolve the backlog.
  • Outdated, niche payments system: Access Healthcare’s workflow management system, arc.flow, provided details on staff efficiency and optimal processes allowing the team to dial in on the right workflow for this unique situation.
  • Efficiency and workflow issues: As efficiency increased month to month and a steady workflow was designed, Access Healthcare scaled back on resources in order to keep costs low and still meet the SLAs.


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