CUSTOMER STORY:
PAM Health’s Inovalon Experience: Exceptional Service, Clean Claims, and Maintained Connections
Background
PAM Health serves medically complex and rehabilitation patients across a network of over 100 long-term acute care hospitals and physical medicine and rehabilitation hospitals, along with wound clinics, outpatient physical therapy sites, and behavioral health hospitals spanning 17 states. The organization is committed to providing high quality patient care and outstanding customer service for all patients it serves.
To maintain a healthy revenue cycle and improve revenue performance, PAM Health leverages Inovalon’s RCM software. Our solutions have helped increase collections, decrease days in A/R, and achieve a higher clean claims rate.
Additionally, having access to our software and a strong relationship with our customer service team has helped PAM Health respond to challenges in its revenue cycle – including an industry-wide connectivity disruption.
Challenge
PAM Health was one of thousands of providers affected by industry-wide disruptions in payer connections, causing a significant delay – or standstill – to its revenue cycles.
The organization turned to Inovalon for help determining a resolution. Losing connectivity caused PAM Health’s processing delayed claims to spike to $5 million at the start of the week. By the next day, Inovalon’s rerouting efforts had processing delayed claims down to just $2.5 million.
For William Borrego, Vice President of Revenue Cycle Operations at PAM Health, Inovalon’s dedicated team made all the difference. He shared, “For us, it was so important to have good communication with our Inovalon support team. Their rerouting of claims was the most important thing that kept our revenue cycle afloat.”
Inovalon’s team worked around the clock to determine which claims had to be reapplied, and they rerouted as many claims as possible for PAM Health. This gave Borrego and his leadership team peace of mind in understanding the status of their claims, and alleviated some of the manual work their billing staff would have had to do without Inovalon’s swift rerouting efforts.
”The visibility to our claims status and what was being rerouted was important for me and for the organization as a whole. We weren’t really scrambling like other providers might have been.”
William BorregoVice President of Revenue Cycle Operations at PAM Health
The Value of the Right Vendor
Prior to an industry disruption in connectivity, PAM Health knew they could rely on Inovalon’s solutions and exceptional customer service. Borrego sums up their experience working with our cloud-based revenue cycle management software as, “So easy to use that most people can go in there and figure it out. The team doesn’t struggle with it.”
For him, it’s the relationships that really make Inovalon stand out.
“The team has been spectacular. When I have a problem, I can pick up the phone and say, ‘Can you help me or give me more information?’ – and that speaks wonders. That personal relationship, almost like a white-glove or VIP treatment, it goes a long way.”
One experience Borrego recalls is when the Inovalon team was fully hands-on to support year-end reporting, even during the holidays. He shares, “We do batch eligibility checks at the beginning of the year and the end of the year, but I was having trouble with the software. I called [Inovalon’s] team the day before Christmas and [they] pulled the whole team together – no one does that during holiday time. Inovalon helped us run our batch eligibility when we needed it and the fact that we could get someone to help us speaks volumes.”
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