CASE STUDY:

RCM for a Multi-Specialty Practice

OVERVIEW
EXECUTION
RESULTS
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RCM Overview

SCALE began working with a multi-specialty practice with approximately forty providers on a host of performance improvement initiatives. The practice decided that it had insufficient leadership and expertise to improve and turn around its billing operation and so it engaged SCALE to provide all RCM services. In a matter of weeks, SCALE took over the billing function and began improving performance.

Why SCALE RCM?

SCALE RCM brings decades of experience building and managing revenue cycle operations of scale. We have developed and refined best practice systems and processes through billing across more than 30 medical specialties as well as numerous sites-of-service and practice management & EHR systems.
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Execution

SCALE successfully took on RCM for a multi-specialty practice with minimal disruption and improved performance in a matter of weeks.

PREPARATION

  • Confirm transition to new billing software
  • Submit proposal to Client
  • Onsite visit to Client
  • Access to Hospital EMR, Lockbox, Clearninghouse

BILLING

  • SCALE began billing for all new claims

OLD AR TRANSITION

  • SCALE to begin old AR project, through completion

EMR & IT

  • Launch new practice management software
  • Enroll in Clearinghouse
  • Confirm transition of hospital practice management software

TAKE OVER CENTRALIZED ELIGIBILITY

  • Complete transition of handling eligibility
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Results

Tight Collection Cycle

  • Days to bill improved by 68% and days in AR improved by 39% despite complication of transitioning billing systems
  • Days to pay improved by 58% and AR greater than 90 days improved by 47%.
  • Five months in, SCALE achieved a tight, industry best practice collection cycle, improving unfulfilled encounters by 68% with the only outstanding claims represented by patient responsibility and claims that were denied or underpaid and needed to be appealed

Improved Internal Coordination

  • Better coordination with internal operations team and less distraction

Practice Performance Improvement

  • Centralizing eligibility has eased onsite burden and resulted in improved performance
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About SCALE

We are a team of healthcare professionals who pair unrivaled business management expertise with comprehensive clinical specialty knowledge. We transform challenge into opportunity and help your business thrive.

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