Establishing a Revenue Cycle Management Team

Service: Revenue Cycle Management

OVERVIEW

Scale Physician Group discovered significant gaps in our Client’s billing department through our initial audit. Our Client had several KPIs that were below target benchmarks such as denial and rejection rates, they received a high number of patient complaints with regards to billing, and many of their providers were not properly credentialed with key plans. The net result was a highly busy practice with negative cashflow, on account of not collecting on all potential revenue and letting a significant amount of claims age.

THE WORK

  • Scale Physician Group’s billing team took over our Client’s revenue cycle management operation.
  • Initial efforts were directed at re-submitting aged claims that had been billed incorrectly and were at risk of lapsing beyond the timely filing deadline.
  • A credentialing employee was brought in to audit the providers, add them to important plans as needed, and develop a tracker and template for in-house maintenance.
  • Our billing team began re-submitting incorrect claims and implementing a new work flow to ensure that verification was happening in all cases, that claims were being submitted correctly, and that billing queries were being addressed in a timely manner.
  • Our team identified numerous services for which the business wasn’t charging (counselling, screening, vaccination, chronic management) and added the appropriate codes.

THE RESULT

The Scale Physician Group’s revenue cycle management team created a best-practice billing department, which resulted in higher revenue, a significant reduction in aged claims, and higher patient satisfaction.

Our Team

Establishing a Revenue Cycle Management Team | Case Study

Bill Ingram

VICE PRESIDENT, ANALYTICS

Bill Ingram is the Vice President of Analytics at Scale Physician Group.

Bill is an experienced strategic operator in the healthcare services space with a background in finance and private equity.

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bobby-trenczer

Robert Trenczer

CHIEF ADVISOR, REVENUE CYCLE MANAGEMENT

Robert “Bobby” Trenczer is the Chief Advisor of Revenue Cycle Management at Scale Physician Group.

Bobby has served as President of CSI Medical Billing for the past 14 years.  In this role, Bobby has achieved mastery of billing for over 30 specialties, practice management systems and EHRs.

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