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How technology transformed a medical billing company’s revenue cycle management

How technology transformed a medical billing company’s revenue cycle management

The past three years have seen increased adoption of technology to support the management of healthcare revenue cycles. Providers are leveraging technology to help improve processes, maximize staff efficiencies and scale their organizations. We interviewed a medical billing company about the effects of technology adoption on the organization’s financial processes.

Q: Can you give a quick summary of your organization and your role?

A: We are 360 Medical Billing Solutions, a medical billing company that provides services to FSER and hospital-based physician groups throughout multiple states. My name is DeNay Cook and I am the Revenue Cycle Management Director.

Q: Why is improving the revenue cycle so important right now for you and your clients?

A: With changing payer demands and new federal regulations regarding hospital billing, ensuring our clients are getting the very best service we can provide is a top priority. The coronavirus pandemic has also opened our clients up to new and massive expenditures recently – taking on additional staff, extra supply usage, overtime hours and extended laboratory testing to name a few.

We feel our medical providers have been the backbone of our community during these last two to three years, overworking and sacrificing to help keep everyone healthy. So, supporting them is something we can help with to do our part for our community. We want to make sure that the first thing on their mind every day is patient care and not payer reimbursements, so we help ensure that they are properly compensated for their work.

Q: Can you share with us some of the ways in which you have improved RCM? Did you change your processes? Adopt technology?

A: In the past two years we fully leaned into new technological advances that maybe some of our clients have been hesitant to use before. We have made numerous updates to our webpage, including our patient payment sites. We have switched into a more advanced partnership with Inovalon. Their ABILITY EASE® All-Payer application has allowed us to keep ahead of changing payer edits and to track our top denial trends more efficiently, so we can address any processing issues immediately. Additionally, we switched from in-house statement printing to using Inovalon.

Q: What has been the impact of these changes and improvements?

A: Productivity increased due to ease of product usage by our staff and faster payer response times. We are able to spend less resources on the back end trying to collect from payers by effectively catching gaps in the front end before we even send the claim to the payer. Our clean claims first-pass rate increased from 92 to 98.5%. And we now utilize e-statements that get a far higher and faster response rate than traditional paper statements.

Q: What’s next for you? When we get together a year from now, what improvements will we be talking about that you have made?

A: Our biggest project so far is our new text to pay feature we will be rolling out as a partner with Inovalon within the next month. We anticipate this will help increase patient payment responses and increase patient revenue greatly. We are very excited to see how this plays out for our company and our clients.

Read the full case study to learn how automation led to greater efficiency and cleaner claims, making 360 Medical Billing Solutions “a better place to work.”


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About the author

David Swenson, Manager, Sales Engineering