Medical Billing Outsourcing Success Stories
Retina Surgery Practice in Southwestern US
The single largest expense of the practice is their pharmacologic agents. Alta and the practice worked together to develop a detailed balancing procedure to assure that from vendor to reimbursement, every dose of their high cost injectables are tracked, billed and reimbursed. Alta also developed custom reporting to provide detailed reimbursement information matching each dose of drug to the specific reimbursement at the line-item level. This information has given the practice definitive proof that every dose is profitable. Alta has also developed custom forms and reports to increase front desk accuracy and reduce work in the benefits department.
Cardiology Practice in Southwestern US
Before working with Alta Medical Management, this cardiology practice experienced three classic symptoms of a sick billing department
1. The practice had inconsistent collections even during times of consistent production and charges.
2. The physicians were troubled by the billing department’s lack of answers to direct reimbursement questions.
3. The overall collection percentage was lower than expected due largely to claims being inappropriately adjusted off and denied claims not being worked in a timely manner.
During the time we have worked together, collections are much more stable and predictable. Physicians now get accurate, timely answers to their questions and denied claims are worked quickly, efficiently and accurately. Most importantly the collection percentage for the practice has increased by 22% and Days in A/R has gone from 59 to 32. Alta has also facilitated consistent, independent chart audits to assure the physicians are coding according to current guidelines, able to appropriately code difficult or unusual cases, and maximize revenue.
Internal Medicine Practice in Western US
Within three months of taking over the billing, the clinic’s cashflow stabilized and began steadily increasing. Within one year of taking over the billing, the clinic’s collection percentage had increased by over 9.8 percent and Days in A/R have been reduced by 11 days resulting in a much more stable, profitable practice.
Alta has also provided the physicians with an unprecented level of reporting and information. Alta has created custom reports varying from physician-level charge lag to reimbursement analysis for newly instituted Medicare-specific codes.
Orthopedic Practice in Intermountain West
Working with Alta enabled the clinic to rapidly expand and focus on taking care of patients – all while maintaining consistent, predictable cash-flow. All metrics at this clinic meet or exceed MGMA standards for best in class. Alta works closely with the clinic to keep denied claims to a minimum, greatly accelerating the cash-flow. Alta billers are in contact with key clinic employees many times each day ensuring work is done correctly, the first time.
Retina Surgery Practice in Southern US
Within nine months, the clinic experienced a 54% reduction in accounts receivable and a 20% reduction in Days in A/R while increasing collections by over 6% through fewer adjusted claims. Working claims efficiently, accurately and in a timely manner are some of our keys to success.
In addition to financial gains, Alta has provided the practice with custom monthly reporting that tracks over 50 different metrics crucial to the success of the practice. Recently, Alta helped the practice closely examine patient waiting times and cancellation rates to identify areas for improvement.
Obstetric and Gynecologic Clinic in Intermountain West
|During our initial assessment of this busy, multi-provider OBGYN clinic, we identified several opportunities to increase revenue. Within the first 90 days, payments increased 10.5%, adjustments fell 15.5% while charges actually decreased 1.7%.|
We were able to drive the increased revenue through several, quickly initiated processes. Although Medicare is not part of their core payer mix, the clinic had not been paid by Medicare in over 14 months. Alta was able to test, implement, send and receive payment on the outstanding Medicare claims within 27 days of assuming billing. Alta quickly identified 27 CPT codes that were being undercharged (and underpaid). In total, the practice had undercharged approximately $253,134 in the prior 12 months. Alta updated the fee schedule and resubmitted all underpaid claims within 60 days.
Alta continues meeting with the physicians each month to continually refine processes, measure improvement and look for new revenue opportunities.
Family Practice in Western US
Within 90 days of taking over the billing, collections had increased over 23% and Days in A/R fell from 87 to 34. Even after working with this clinic for over six years, the focus remains on continually improving processes and driving higher reimbursement. Quarterly physician meetings focus on identifying areas for improvement and implementing new processes to increase both collections and patient satisfaction. Today, this client is a model clinic whose physicians own their own building, take regular time off to travel and are able to spend time with their growing families.
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