A Texas-based substance abuse facility was facing a dire financial situation. Having worked with two billing companies unsuccessfully in a span of just one year, it was struggling to collect payments for its outpatient claims. Additionally, the facility had not received a single payment from Blue Cross of Texas for its residential treatment services in over two years due to a contractual issue.
The Texas facility was experiencing both frustration and financial instability as it sought a solution to turn its billing problems around. This is where we stepped in to provide its expertise and support.
An adolescent mental health residential facility that needed financial recovery and billing overhaul reached out to us for help. We were initially engaged for a billing department evaluation, but then we uncovered severe issues hurting its operations. The facility’s Director had been outsourcing tasks to external entities, while the in-house claims team was inadequately trained. Failure to file claims in a timely manner had resulted in the potential write-off of over $4 million in claims. In addition, the facility was under pre-payment review with their largest payer, Anthem, adding to the financial strain.
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