Rural Hospital AHR437*Rural Hospital

casestudy-AHR437

This 25 bed facility is located in a low income rural community. It is a non-profit, community-owned hospital that serves a population of approximately 20,000.

challenge

This facility had significant compliant issues. The IMM (important message from Medicare) was not being given to Medicare patients when they were being admitted to IP. The hospital’s billing department was applying modifiers to charges without verifying the charges. There were also charge master issues and invalid revenue CPT code combinations that were being billed to the payers. Claims were being billed with the incorrect Type of Bill. The billers were making changes to the claims instead of the departments.

solution

The hospital’s coding issues became evident during our initial assessment of the revenue cycle process. We began by clearing up the Medicare compliant issues and fixing the numerous coding errors. Our solution involved assisting, monitoring, and then re-training hospital employees on the correct policies and procedures. To date, our team continues to manage the accounts receivable and collections of hospital’s patient revenues and oversees the claims filing and follow-up to ensure optimal results.

results

Before

  • Days in AR- 73.7
  • Total AR>90 Days – 26.9
  • Bill Hold Days – 4
  • Bad Debt – $590k
  • Cash Collections – $564,000

After

  • Days in AR- 37
  • Total AR>90 Days – 18.2
  • Bill Hold Days – 4
  • Bad Debt – $350k
  • Cash Collections – $1,129,907
how can we help you?

Contact us at the Ascentium office or submit a business inquiry online.

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