A full-service medical billing and claims management company specializing in anesthesia services. They serve 100 health care clients across the country and employ 50 full-time onshore employees.
Overview
A mid-sized medical billing company was faced with ongoing staffing difficulties which impacted their ability to meet key performance indicators (KPIs) for existing clients, as well as limited their capacity to onboard new clients.
“We never had to outsource in the past, so it was very new to us, but times had changed, and we had to think outside the box to identify ways we could sustain the company and get the work done even when we didn’t have enough people.”
Solution
In October 2023, the company decided to partner with Global Healthcare Resource to build a team of 15 FTEs assisting with portions of their A/R Follow-up, Coding, Charge Entry, and Payment Posting processes. The new offshore strategy allowed them to maintain consistent staffing levels, provide uninterrupted services, and onboard new clients quickly.
Full Story
Costly staff turnover had begun to take its toll on one medical billing and claims management company specializing in anesthesia services. “Employees would join us, get experience and training for a few months, and then move on,” said the Director of Revenue.
It was also difficult to find and retain those with experience because salary requirements were too high. “Meeting these requirements just wasn’t sustainable with our business model of charging a percentage of collections,” she added.
“It’s hard because everyone looks good on paper, but they may not be able to do the work. I’ve gotten burned a couple of times,” she said.
These persistent staffing challenges had started to affect the company’s ability to meet client key performance indicators (KPIs). This was especially true for KPIs related to increasing commercial payer denials that required specialized knowledge.
While the company had implemented various strategies to attract and retain top talent, many weren’t successful. That’s when the Director of Revenue decided to move in a different direction by pursuing an outsource partnership.
“We never had to outsource in the past, so it was very new to us, but times had changed, and we had to think outside the box to identify ways we could sustain the company and get the work done even when we didn’t have enough people.”
In October 2023, the company decided to partner with Global Healthcare Resource to build a team of 15 FTEs assisting with portions of their A/R Follow-up, Coding, Charge Entry, and Payment Posting.
Now, the company maintains consistent staffing levels, providing clients with uninterrupted services. In addition, the Director or Revenue no longer spends valuable time searching for employees who may not ultimately have the right knowledge and experience.
Results
Taking on New Clients with Ease:
The partnership with Global Healthcare Resource also mobilizes the company to take on new clients. “We just onboarded a very large client, and Global was definitely a big help,” said the director of revenue. “I didn’t need to hire additional resources. I said, ‘I need five people,’ and I had them in fewer than 24 hours.”
Exceeding Client KPIs:
With the help of Global Healthcare Resource, the company far exceeds client expectations for turnaround time, avoidable write-offs, and other critical KPIs. That’s largely because Global Healthcare Resources maintains high quality standards for its own staff and also leverages offshore talent to increase availability.
“The Global team has a vast knowledge of insurance and A/R follow-up. Their teams also work in the off-hours throughout our night. I get my A/R touched 24 hours a day,” she said.
In addition, having a backup plan for staffing vacancies means she can focus on internal quality controls. More specifically, she doesn’t feel pressured to retain direct employees in their current roles when those roles aren’t a good fit for them. “Because of Global, I can now shift those employees away from complex tasks toward transactional work instead.”
Finally, Global Healthcare Resource arms her with detailed reports that shed light on problematic areas across her entire client base. “We have more than 100 clients, and we enter about $32 million in charges a month. Global helps us drill down into root causes of denials and rejections by client. Is it a billing error? Coding error? Problem with eligibility? Billing companies normally don’t have that level of insight. But with Global’s help, we do, and we can pass those insights on to our own clients.”
Since November 2023, Global was able to identify the top ten error trends and correct over 38,000 claims valued at $16.5M in total A/R.
Cost Savings:
By offshoring portions of their coding, payment posting, data entry and A/R follow-up processes to Global, the Medical Billing Company is seeing operational savings of approximately $500,000 annually.
New and Sustainable Business Strategy:
Global Healthcare Resources promotes a true partnership with the coding and billing companies it serves. “They are an extension of your team, and they’re ‘all in’ for you,” said the Director of Revenue.
Dedicated account managers make the outsourcing process hassle- and stress-free, allowing leaders to focus on high-value tasks.
“I can always text or call my account manager,” she said. “When something is wrong, he handles it immediately. You don’t normally get that type of personal touch with a lot of outsource companies. Global makes the transition so easy. It’s worry free for me because I know they’ll get the work done.”