CASE STUDIES
The following cases are based on real data for active Integra clients that have received the benefits of our service value proposition. Take a minute to read how we have successfully helped clients better manage their revenue cycle and improve their bottom linehere
CASE STUDY 1
Focusing on Accounts Receivable
Profile: Three Physician Practice Group
Problem Prior to Engaging Integra MDP
Continual increase in aged accounts receivables placed a financial strain on the practice. At the time of takeover, current month billings only represented 20% of the total AR.
Integra MDP Action Plan
Initial analysis identified 2 separate root causes for the receipt deficits and four immediate improvement opportunities to further reduce Days Revenue Outstanding for the practice.
A thirty day action plan was developed and implemented to address the structural issues faced by the practice. Specific, Measurable & Actionable items were tracked and reported through Integra’s Client Portal with Key Performance Measurement Dashboards depicting real-time results. Results were discussed with the Practice Leaders during monthly business meetings along with newly identified performance improvement initiatives uncovered during the prior month.
End Result
Aged AR reduced from 80% of total AR to 40% of total AR within 90 days.
Days Revenue Outstanding (measurement of time between patient encounter to first insurance dollar received) reduced by 65% over the first 6 months
Net Collection Revenue (revenue plus adjustments expressed as a percent of charges) increased from 82% to an average of 108% per month after 90 days.
Real Revenue increased by over 22%
CASE STUDY 2
Focusing on Insurance Contract Problems
Profile: Multi Location Urgent Care Group
Problem Prior to Engaging Integra MDP
Significant denial and underpayment of claims against anticipated results were being experienced for both commercial and Medicare claims.
Integra MDP Action Plan
Analysis was completed against prior six months of claims experience to identify root cause for poor claims performance from prior vendor. Integra identified two primary causes impacting over 92% of the subpar results; Expired Contracts with commercial payers and poor management of credentialing for newly hired physicians and NPP’s.
Integra immediately identified the non-compliant providers and managed the practice group team in closing all credentialing efforts. Further, we recommended changes to the new hire process for the group to better manage credentialing. Additionally, we worked with the client team to instill processes that segregated providers to patient groups for which they were compliant (Medicare vs. Commercial/Self).
On a parallel track, contracts were updated with each expired payer and new contracts were executed based on utilization reports which identified out of network payer patient volume trends.
A thirty day action plan was developed and implemented to address the structural issues faced by the practice. Specific, Measurable & Actionable items were tracked and reported through Integra’s Client Portal with Key Performance Measurement Dashboards depicting real-time results. Results were discussed with the Practice Leaders during monthly business meetings along with newly identified performance improvement initiatives uncovered during the prior month.
Above core changes were completed within 4 months.
End Result
Real Revenue increased 600% for the compliance groups with an overall impact of 19% as measured against the entire practice.
After 6 months, 90% of all claims were closed within 30 days of the date of the encounter.
Days Revenue Outstanding (measurement of time between patient encounter to first insurance dollar received) reduced by 71% over the first 6 months
CASE STUDY 3
Focus on Days Revenue Outstanding
Profile: Two Physician Practice Group
Problem Prior to Engaging Integra MDP
While collection percentages were within industry norms, the Practice was experiencing continual cash flow issues due to the amount of time it took them to collect insurance receipts.
Integra MDP Action Plan
Initial analysis identified a lack of automation in claims submission and management coupled with a minimal utilization of ACH/EFT reciting structures.
A new practice management platform was implemented by Integra to support full automation in claims submission for over 96% of the payer groups seen by the practice. Payments were shifted to ACH with same day posting through ERA management. A full team was assigned to manage the transition and support the practice through rollout. Core Integra team members remained as the billing department for the practice and drove all revenue cycle management.
A thirty day action plan was developed and implemented to address the structural issues faced by the practice. Specific, Measurable & Actionable items were tracked and reported through Integra’s Client Portal with Key Performance Measurement Dashboards depicting real-time results. Results were discussed with the Practice Leaders during monthly business meetings along with newly identified performance improvement initiatives uncovered during the prior month.
End Result
Days Revenue Outstanding (measurement of time between patient encounter to first insurance dollar received) reduced from 65 days to 18 days over the first 6 months
After 6 months, 90% of all claims were closed within 30 days of the date of the encounter.
Real revenue adjusted for patient volume increased by 6% over the same period
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