Practice: Mid-sized behavioral health provider staffed with physicians, nurse practitioners, psychologists, social workers, etc.
Patient Volume: 143k per year
Revenues: $14m per annum
Billing /Posting Delays: 9-days
Insurance Follow-up: 65-75 days after submission and the data entry
Current Billing Solution: In-house billing
Situation: Significant coding errors and Pre-authorizations and pre-certifications were often missed, and a side effect of the slow billing was that balances were transferred to patients without follow-up to the insurance companies resulting in patients receiving bills, which caused a great deal of frustration and phone calls. The problems were not only on the billing side, however; as no-shows and cancellations with less than 24 hours notice were through the roof.
HealthQuist’s dedicated client team was able to step in and help overhaul the practice’s existing system and replace it with HealthQuist’s system while still maintaining and tracking aged claims on the existing system. With training on the new system at multiple locations handled by HealthQuist, they were able to bring on board updated scheduling, ledger systems and more with no appreciable downtime.
Keeping things organized with a multisite practice can be challenging, so the front desk now has access to a daily schedule which is printed and distributed to providers for billing markups which are all scanned back to HealthQuist on the same day. With the integrated scheduling system, HealthQuist is able to ensure that all patient visits are pre-authorized, which helped patients visit the practice free of worry about denials and appeals.
Charging also received an overhaul, with audits and electronic filing to the insurance companies helping to get reimbursement in house much more promptly, while reducing the follow-up time for A/R claims. With HealthQuist acting as an insurance go-between, the practice was able to identify contracting and coding issues with IOP resulting in an increase in IOP payments from an average of $112 to $168. Finally, HealthQuist’s helped implement a $50 no-show/cancellation policy to be signed by each patient; an action that has significantly reduced the no-show/cancellation rate.