A multi-specialty medical group with six providers was frustrated by the lack of visibility into their billing data. Their previous billing company provided limited reporting and delayed updates, making it difficult to track claim performance, denial trends, and overall revenue. The lack of transparency created uncertainty and hindered strategic decision-making. The practice switched to a PerceptGo who offers real-time reporting and transparent communication.

Conclusion

Transparency in billing is key to financial success. This medical group’s experience highlights how real-time data and clear communication can transform billing operations and revenue performance.

Client feedback

Our new billing partner’s transparency changed everything. We can now see exactly where our revenue is coming from and where we need to focus. The increase in collections is just one of the many benefits.

Challenges

• Limited Reporting: Monthly summaries lacked actionable insights, leaving the practice unaware of denial trends and cash flow issues.
• Delayed Updates: The practice often received outdated billing information, leading to missed opportunities to correct errors.
• Revenue Leakage: Without clarity on rejected or unpaid claims, the practice lost potential income.
• Trust Issues: The lack of transparency eroded trust between the practice and the billing provider.

Solution

• Inhouse KPI Dashboard: Provided real-time access to metrics such as claim status, denial rates, and days in AR.
• AI Integration: Recognize denial patterns and reasons to suggest proactive and preventive strategies to reduce errors and denials.
• Detailed Reports: Delivered weekly and monthly breakdowns, highlighting trends and areas for improvement.
• Collaborative Problem-Solving: Proactive communication with the practice to address bottlenecks and optimize the revenue cycle.

Results

• Improved Collections: Enhanced visibility into denials led to quicker resolutions, increasing revenue by 20%.
• Reduced Days in AR: Faster identification of unpaid claims reduced the AR cycle from 60+ days to 29 days.
• Informed Decision-Making: Real-time access to billing data empowered the practice to make strategic financial decisions.
• Renewed Trust: The transparent reporting and communication restored confidence in the billing process.

A gynecology clinic with two providers faced significant challenges in managing billing for complex procedures such as laparoscopic surgeries, hysteroscopies, and infertility treatments. The previous billing team struggled with coding intricacies and payer-specific requirements, leading to denied claims and delayed reimbursements. The clinic partnered and hired PerceptGO RCM service for gynecology and obstetrics billing.

Client feedback

PerceptGo truly understood the complexities of gynecology billing. They not only fixed our issues but also helped us recover lost revenue and improve our overall operations. We’re now able to focus more on our patients and collect higher reimbursement from payers.

Conclusion

This gynecology clinic’s story illustrates how partnering with a our RCM services can resolve complex billing issues, reduce denials, and enhance financial performance.

Challenges

• Procedure Coding Errors: Complex gynecology procedures often required multiple CPT codes, and incorrect bundling resulted in claim rejections.
• Inconsistent Documentation: Lack of detailed clinical documentation delayed claims processing.
• Frequent Preauthorization Issues: Procedures like fertility treatments required pre-approvals, which were often missed or mishandled.
• High Denial Rate: Over 27% of claims were being denied, severely impacting cash flow.

Solution

• Expert Coding and Bundling: Certified coders ensured accurate coding for complex procedures, preventing unbundling errors.
• Documentation Training: Conducted staff training to improve clinical documentation and meet payer requirements.
• Preauthorization Management: Established a robust preauthorization process to handle high-complexity procedures efficiently.
• Denial Analytics: Performed root-cause analysis of denials and implemented strategies to prevent recurrence.

Results

• Denial Rate Reduced to 5%: Accurate coding and better documentation drastically improved claim acceptance.
• Faster Approvals: Streamlined preauthorization processes reduced delays in treatment approvals.
• Revenue Growth: Collections increased by 25% within six months, recovering lost revenue.
• Operational Efficiency: Administrative staff saved time on rework, focusing on enhancing patient care.

A busy multi-specialty provider’s office was struggling to manage the increasing volume of patient calls. Appointment scheduling, prescription refills, and billing inquiries were overwhelming the front desk staff, leading to long hold times, missed calls, and frustrated patients. This inefficiency was not only affecting patient satisfaction but also hindering the office’s ability to focus on in-person care. The provider partnered with PerceptGo to implement a dedicated patient call center.

Client feedback

Partnering with PerceptGo was the best decision for our practice. Their patient access team is professional, courteous, and truly understands the needs of our patients. We’ve seen a noticeable improvement in patient satisfaction and operational efficiency. It’s a win-win for both our team and our patients.

Conclusion

Partnering with PerceptGo streamlined call management, improved patient satisfaction, and allowed the practice to focus on in-person care, boosting efficiency and retention.

Challenges

• Overload of Patient Calls: Struggled with a high volume of patient calls overwhelmed front desk staff, disrupting daily operations.
• Inefficient Management: Struggled with appointment scheduling, refills, and billing inquiries, causing errors and delays in service.
• Negative Patient Experience: Long hold times and missed calls led to frustration and dissatisfaction among the patients.
• Reduced Focus on Care: Phone management distracted staff from providing quality in-person care to the patients.

Solution

• Strategic Partnership: Partnered with the provider to implement a dedicated patient call center, allowing for a more efficient handling of patient calls.
• Efficient Call Center Management: Seamlessly extended the practice, managing all incoming calls with professionalism and speed.
• Comprehensive Call Handling: Managed appointments, insurance, and billing inquiries, easing the practice’s administrative load.
• Improved Patient Experience: Enhanced service speed and efficiency, boosting patient satisfaction and allowing more focus on direct care.

Results

• Improved Patient Satisfaction: The average call wait time dropped by 60%, and over 95% of patient calls were answered within the first minute.
• Increased Efficiency: Front desk staff could focus on in-office patients without being interrupted by phone calls, improving workflow and productivity.
• Increased Appointment Retention: Proactive follow-up calls and reminders reduced no-shows by 25%, leading to more patient visits and higher revenue.
• Cost Savings: By outsourcing their patient call management, the provider reduced overhead costs associated with hiring and training in-house staff.