- Case Studies
Learn What Revenue Cycle Strategies Worked for a Podiatry Practice
Discover how our Medicare podiatry RCM experts improved compliance and cash flow for a Houston-based practice using a 7-step strategy, despite eCW challenges.
Table of Contents
Introduction
A 3 physician podiatry practice based in Houston, Texas. The podiatry practice specialized in diabetic foot care and custom foot orthotics. It had a stable influx of patients and a diverse payer mix. It is one of the popular podiatric practices in the area.
Challenges
Poor collections, high claim rejection rate, unresolved denials and the in-house billing team’s inability to work with the eClinicalWorks EHR were the major complaints of the podiatrists. They wanted to work with a team of medical billing experts who were experienced in working with eClinicalWorks and familiar with podiatry codes. The podiatry practice felt that teaming up with professionals who were experienced in both, working with eCW and proficient in podiatry coding could improve their revenue.
Our Solution
Medientsky Billing, upon request, provides potential clients the opportunity to communicate with our existing clientele. After speaking to a few of our podiatry and eCW clients the podiatry practice was willing to sign up for our services. After a brief meet-up at their office, we deployed a dedicated podiatry billing team and account manager to handle day-to-day billing tasks.
Conduct LRRA
We realized that the practice was facing severe coding issues and underperforming payer contracts. After conducting an end-to-end Lost Revenue Recovery Audit (LRRA), we identified the sources of revenue leakage and devised appropriate remedies to tackle them. Our CPC & CRC certified revenue auditors brought to the surface the myriad errors such as misuse of modifier 59 and erroneous codes assigned for routine foot care during the audit. The 19, extensive revenue audit reports we offered enabled the podiatry practice to make much-needed course corrections.
Provide Credentialing & Contracting Review
Since credentialing and contracting is the backbone of medical practices we offer a free Credentialing and Contracting Review (CCR) for medical practices. We have experienced specialists with a combined experience of 50+ years to handle the credentialing and contracting needs of practices. The podiatry practice was being routinely underpaid for physical therapies. We identified major variances between contracted rates and the reimbursement received. After compiling necessary documentation to appeal repeated underpayments we worked closely with the insurance company to recoup $30,000. The podiatry practice was also looking to add an additional podiatrist and anaesthesiologist on board. Our credentialing experts handled the entire credentialing process.
Deployment of Temporary Resources
The podiatry practice wanted our medical billing team to hit the ground running as unbilled claims were piling up. To offer immediate assistance Medientsky Billing deployed a team of 3 podiatry billing specialists and CSFAC credentialed coders to handle the urgent medical billing and coding requirements of the practice.
Denial and AR management
High percentage of pending accounts receivables and preventable denials were the Achilles toe of the medical practice. Medientsky Billing has developed intuitive, full-featured and powerful denial prevention and AR management systems to curb lost revenue. Our denial management system bubbled up recurrent denial patterns. This helped us to put together a strong and extensive denial prevention strategy. Our AR management system, ARAnalyzer, enabled our AR management team to prioritize and categorize AR to streamline the AR calling process.
Onsite Transition
The regional manager of our Texas office, Kim Dues and podiatry revenue cycle specialist, Steve Watson, drove over to the podiatry practice to ensure a hassle-free transition. After analysing current workflows and understanding the major operational and financial issues faced, our experts created a practice-specific roadmap that intersected with the existing workflow of the podiatry practice to avoid disruptions.
Go-live
After comprehensive revenue and compliance audits Medientsky Billing was all set to become the revenue cycle management partner of the practice. It has been 7 months since we started working with the Texas based podiatry practice.
Results
Conclusion
The partnership between the Houston podiatry practice and Medientsky Billing has led to significant improvements in their revenue cycle. By addressing key issues such as poor collections and high claim rejections, and through our comprehensive Lost Revenue Recovery Audit and Credentialing & Contracting Review, we recovered $30,000 and resolved numerous coding errors. The deployment of specialized billing resources and the integration of theBillingBridge app have given the practice control over their finances. Our denial and AR management systems have reduced preventable denials and improved accounts receivable management. Seven months into the partnership, the practice now enjoys a streamlined revenue cycle and enhanced financial health, allowing them to focus on patient care. Medientsky Billing’s support has transformed their revenue management, setting them up for continued growth and success.
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Highlights
- Achieved 50% increase in overall net revenue
- Secured 76% more in patient collections
- 97% Reduction in coding errors achieved
Client Specs
- Location: Washington
- Specialty: Behavioral Health
- EHR: Incredible
- Average collections: 300K per month
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