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End-to-end Revenue Cycle Management – Anesthesia

Background:

The client is a large Anesthesia Group with 28 doctors and CRNA's (Nurse Anesthetist) doing Obstetrical and General Anesthesia in tertiary level surgery hospital. They are located in the mid-Atlantic area and are billing approximately $20 million in charges per annum. Improvement in delivery standards by way of better data input quality, shorter Turn around Time (TAT) and a more intensive AR follow up coupled with much more competitive pricing prompted the client to outsource their entire revenue cycle management process to Medusind Solutions.

Key Challenges:

• Coordination and workflow management between Coding and Charge Entry leading to delayed cash receipts.
• Deadline for the month close is the first working day of every month and to ensure that all pending clarifications are resolved before the month-close with the Physicians. THIS HAS TO BE REWORDED Agree. Please reword the message here.
• Handwritten and illegible demographic documents leading to long pending clarifications logs.
• Insufficient documentation by doctors leading to reduced reimbursement per CPT.

The Medusind Approach & Solution:

• Identify and Analyze the root causes to fix front-end related issues.
• Focus on operational efficiency to eliminate unwanted processes.
• Streamline processes for proper co-ordination between various departments.
• Experienced and certified team members in place.
• Physician Education on proper documentation leading to correct coding, the very first time.
• Regular update dissemination of Federal Laws and policies.
• Implement rigorous quality processes for continuous improvement.
• Clear pending reports which are resulting in rejections on a priority basis.
• Prompt attention to Denials & ECS rejections processing.
• Regular reporting to Client with value added statistical analysis.

Benefits to Client:

• Client benefited with increase in cash flow in a very short timeframe (Client had an average monthly collection of $350,000 before outsourcing. Medusind's handling of the end-to-end processes resulted in an average increase of $$35,000 to $40,000 per mont accounting for 10% to 13% top line growth)
• Seamless transition of delivery of the account with services like Credentialing and Enrollment, Medical Coding, Demo & Charge, EDI Transmission, Cash Posting, Account Receivables & Correspondence Management to Medusind.
• Within two months, Client achieved a month end closing date on the first working day of the month (The Client on their part had taken more than a year to achieve this deadline date.)
• Lower Operating costs due to outsourcing of the complete end-to-end delivery to Medusind.

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