Over the last few years, a well-known pediatric treatment and research facility had begun to experience a noteworthy decrease in third party and government payer revenues due to bad debt, slow cash collection, and an increase in accounts receivable — especially in the 90 days and greater category.
Warbird’s AR Specialists Team reviewed and corrected, then prepared and re-submitted hospital claims to the third-party payers. The client’s billing processes were used to get the claims paid promptly and accurately. Warbird established a formal denial tracking method that recorded details for all denied claims, the steps required to appeal the denial, and appeal results, helping to identify denial trends by payer, denial type, and denial type by hospital department. All files containing AR inventory were reviewed and provided to the client for further process improvements.
The facility saw a reduction in denials, improving revenue — including a documented improved cash collection of $3.2M with a pending cash collection of $2.2M. The backlog of denials decreased, reducing AR inventory by 34.6%. The ratio of “Cost of Project” to “Return on Investment” ($3.2M) was 1 to 5.
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