As a healthcare provider, patient care is your prime responsibility. But do you find yourself spending more time on administrative tasks and processes instead? If you just said yes, then this 3-minute read could change things around for you.
A Texas-based mHealth IT solutions firm relied on a paper-based system for all tasks right from collecting patient information, setting appointments, creating treatment plans to managing payments. However, as the clientele grew, the CEO realized that resource utilization management, updating patient data, and payment tracking became increasingly difficult.
OSP understood all the issues and built a customized digitized practice management system supported by the RCM system that addressed all the business challenges. Not only that, we went the extra mile to provide a robust and advanced solution that automated the complete appointment-to-payment process with an array of features such as insurance verification, patient pre-authorization, automated AHQ-9 assessment, co-pay management and much more…
This investment made a significant difference – within a year of implementation of this system, these were some of the achievements:
$1.1M in savings
70% reduction in thedaily administrative workload
15% increase ineveryday collections
Manual handling of practice management and the RCM system affected not only through the loss of revenue but also the quality of care delivered. These were some of the challenges that were negatively impacting the business
- Longer Revenue Cycle – As the firm managed everything manually, completing the whole revenue cycle – from the time a patient makes the first appointment to when no balance is left on that patient’s account – took a long time. This process frustrated both the staff and the patients.
- Fragmented and Slower Billing Process – The bills were saved in different places in the form of papers and files, and the manual verification of the insurance eligibility of each client slowed down the billing process.
- Low Revenue Per Billing – Despite having more patient visits than before, the clinic was losing revenue because of inaccurate and inefficient billing and payment methods.
- Incomplete Filing of Claims and Higher Claim Denials – Manual generation of claims resulted in the incomplete or incorrect filing of claims. Claim denials were also one of the reasons the clinic was losing revenue as they were not getting paid for the services they rendered.
The main task for OSP was to automate the clinic’s daily practice and revenue operations. We started by first analyzing the current situation and then breaking it down into four operational areas that needed attention – Care Focused, Usability, Interoperability, and Integrated. Each of these was then further divided into segments to address, and solve the various challenges as shown below:
In the digitized revenue cycle management process, scheduling an appointment, registration of a first-time patient, insurance eligibility verification, and patient pre-authorization is automated with teleconferencing to enhance the patient’s care experience. We added all the relevant medical codes and Wiley Notes in the system that makes it easy to generate patient treatment plans and saves providers more time for patient care and communication. The charge entry, payment posting, and A/R recovery programs ensure a hassle-free billing process. The system then sends a statement and a notification about the remaining balance (in co-pay cases) to the patient. It also sends alerts to patients who need to clear outstanding dues.
Well, let the numbers do the talking.
In addition to the quantifiable accomplishments listed above, the clinic also reported the following benefits:
- Increased timesavings
- Decreased staffworkload
- Enhanced servicecapacity
- Better patientengagement
- HIPAA compliant,scalable system
The paradigm shift from the traditional paper-based process to custom-made practice management and RCM systems boosted the clinic’s productivity and success. Our integrated healthcare management solution helped them save time and money and cater to more patients in a day. All of this translated into tremendous growth in revenue.
Currently, we are in the process of integrating DrFirst, a leading e-prescribing, and medication management solution and building a personalized chatbot to boost the existing system and make life easier for providers and patients.
OSP can customize integrated health care management solutions for different medical processes and environments like dental billing, private practices, FQHCs, and hospitals.
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Written by Riken Shah linkedin
Riken's work motto is to help healthcare providers use technological advancements to make healthcare easily accessible to all stakeholders, from providers to patients. Under his leadership and guidance, OSP Labs has successfully developed over 600 customized software solutions for 200+ healthcare clients across continents.