From Healthcare Claims Novice to 5X Monthly Collections

Roots Food Group delivers medically tailored, ready-to-eat meals to people with chronic illnesses. They’re experts at using food to help patients manage conditions from hypertension to heart disease, but one thing they weren’t prepared to manage? Medical billing.

The challenge began when payers updated their claims to include a code for community support. Suddenly, instead of sending traditional invoices, the company had to learn to navigate the notoriously complex healthcare claims process, and fast.

Roots Food Group leveraged Inovalon’s revenue cycle management solutions to simplify its financial operations in three key ways.

Create clean claims in bulk

When the new payer requirements took effect, the company resorted to manually converting each invoice to a claim, entering every piece of data by hand. At this pace, they could handle one to two claims at a time – not nearly efficient enough to keep up with the hundreds of meals they were delivering each day.

With Inovalon’s Claims Management Pro™, Roots Food Group is able to easily convert hundreds of claims into the correct format in one step. A built-in scrubber ensures claims follow the latest payer rules, reducing errors to keep reimbursements flowing smoothly.

“Now, we do our billing in bulk and can trust the claims are correct,” says Kimelyn Coleman, Director of Revenue Cycle.

Spot changes in members’ coverage

Any doctor’s office or hospital is familiar with how fast patient eligibility can change, but this wasn’t so obvious to Roots Foot Group as first-time medical billers. They discovered that meal recipients would sometimes lose eligibility between the time they placed an order and the time of the delivery, leading to problems capturing payments.

With Inovalon’s Eligibility Verification Standard™, the company ensures it always has the correct coverage details on file and stays abreast of any changes.

Easily see and share performance updates

Roots Food Group’s hands-on approach means the less time they spend in front of a computer compiling data, the better. Inovalon’s RCM Intelligence™ lets company leaders pull insight-rich reports with a few keystrokes.

“I can get the data that we need to provide our finance department and it’s ready to paint the picture with charts and graphs,” says Coleman. “I can just download and send.”

Beyond efficiency: bottom-line impact

With one-on-one guidance from Inovalon’s implementation and training teams, Roots Food Group’s billers got acclimated to their new workflows, learned time-saving shortcuts, and quickly adapted to the world of healthcare claims. But it wasn’t just billing efficiency that received a boost — the company saw a five-fold increase in monthly collections.

Learn more about their journey from one-claim-at-a-time manual processing to automated billing. Read their success story.

Could your revenue cycle management processes use a similar upgrade? See how Inovalon’s solutions can help you gain speed, efficiency, and accuracy across the entire revenue cycle.

Request your demo now.

Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.