Coding Expertise Maximizes ED Revenue

Dr. Scott Schlais, President of Fort Atkinson Emergency Physicians (FAEP), needed to act fast.

The six-doctor emergency medicine practice had begun a drastic reorganization process due to serious deficiencies caused by a previous billing company.

  1. Failure to deliver FAEP’s full income potential due to insufficient coding knowledge.
  2. Lack of understanding of FAEP’s practice specialty, goals and objectives.
  3. No training or support to educate FAEP’s staff when changes were required.

Dr. Schlais and his associates decided to make a change to a full-service revenue cycle management firm with a consultative approach and the coding knowledge required to maximize their revenue.

HERE’S THE STORY 
Full-service Revenue Cycle Assessment

1. Provider Contract Review. The ebix team began by reviewing FAEP’s provider contracts to investigate if maximum revenue was being received from insurance payers.  This lead ebix to also renegotiate FAEP’s insurance contracts to ensure better payment terms.

2. Dedicated Team Assigned. Concurrently, ebix assigned a member from each of their departments to form a dedicated team to audit and analyze FAEP’s processes and highlight any key areas for improvement. Missing documentation, inaccurate coding and inconsistent processes were uncovered; leading to a high percentage of urgent care and emergency care service billing errors.

3. Physician Education. As a result of the audit, ebix established monthly encoding documentation and physician education sessions that would work to provide consistent training resources and feedback for FAEP. This also enabled ebix’s team to create new Urgent Care guidelines, which enabled FAEP to better expedite patient care and improve patient satisfaction with Urgent Care Services.

IMPACT – EXCEEDED EXPECTATIONS AND REVENUE GOALS

  1. Accounts receivable days outstanding also improved by nearly 10 days.
  2. With ebix, custom reports/data analytics bridged a missing communication link for FAEP.
  3. 15% increase on the average rate of reimbursement from three major payers.

Extended Reading List:

Real Story Coding Expertise Maximizes ED Revenue PDF

Revenue Cycle Management (RCM) Service

Benefits of Choosing a Medical Coding Service

Minimize Medical Claim Denials