Services to a Medical Management Firm
Client Overview
The client is a Medical Management organization that serves hospital groups, private medical practices and physician offices. Their main domain is revenue cycle management. Their services are designed to maximize their client's profitability by managing costs and plugging revenue leaks through consultations and employee management.
Challenges
After the initial rounds of the discussions with the client, the following challenges were identified:
1. In-house medical coding practices are inefficient, time-consuming and often result in revenue contraction. Another issue is that physicians tend to under-code for the services rendered to the patient with a fear of claim rejections. This results in losses on potential legitimate revenue opportunities.
2. Physicians were not efficiently completing encounter notes and were missing key details entries.
3. Consolidation of miscellaneous services such as after-hours prescription request
handling, answering services, appointment management can free up non-medical staff time, increase productivity and improve patient satisfaction
Solution and Outcome
On the back of our initial problem identification exercise, we were able to design bespoke solutions for our client. Our services targetted streamlining the medical coding, clinical data and non-medical staff processes. As a result of this partnership, we were able to achieve the following:
a. Patient no-shows down to 5% from 27%
b. Repeat calls by the patients due to non-availability of full-time staff down 85%
c. The prescription refill process was streamlined.
d. Patients could reach a live attendant during federal holidays as well.
e. Full-time work burnouts considerably down and job satisfaction improved.