CASE STUDY:

Billing for a Multi-Specialty Practice

Overview

SCALE began working with a multi-specialty practice with approximately forty providers (across Nephrology, Cardiology and Primary Care) 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.

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.  Learn more.

Execution

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

STEP 1:

Preparation

Confirm transition to new billing software

Submit proposal to Client

Onsite visit to Client

Access to Hospital EMR, Lockbox, Clearninghouse

STEP 2:

EMR & IT

Launch new practice management software

Enroll in Clearinghouse

Confirm transition of hospital practice management software

STEP 3:

Billing

SCALE begin billing for all new claims

STEP 4:

Take Over Centralized Eligibility

Complete transition of handling eligibility

STEP 5:

Old AR Transition

SCALE to begin old AR project, through completion

Results

Tight Collection Cycle

60 days into our engagement, over 80% of expected collections had come in compared to 97% outstanding collections when we began

Five months in, SCALE achieved a tight, industry best practice collection cycle 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

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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Provider Platform Engagements Since Inception

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Providers Across Our Platform Partners

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States Our Platform Partners Operate Across

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Operational Disciplines and Clinical Service Expertise Offered by Scale

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