Copyright © 2024 Claros. All rights reserved.
The client is headquartered in the Midwest and has 8 physicians in the group.
The client contacted us about issues in their end-to-end revenue cycle process.
1. Worked to ensure that current claims are processed correctly.
2. Analyzed the EMR system to understand the issues and prioritized them effectively to maximize revenue.
3. Cleaned up double postings to reduce credits and maintain a correct accounts receivable.
1. Cleaned up double insurance and patient payment postings.
2. Developed a proper surgical process to minimize claim denials.
3. Created a monthly performance reporting system to provide financial clarity for the business.
4. Improved the claims follow-up process to collect claims revenue in a timely manner.
5. Reduced claims denials by 50%
The client has five offices and nine providers in the group. The client has been in business for 18 years and is headquartered in the Northeast.
Client identified issues in their RCM and Accounting processes such as:
1. Double posting of payments
2. Open claims worth $600K
3. Old insurance contracts
4. Newly purchased 3 offices for growth
5. No clarity on monthly cash flow and profitability
1. Cleaned up older postings to reflect proper A/R aging.
2. Improved current claims processing by lowering denial rates.
3. Switched from an in-house accounting system to a web-based solution.
4. Started negotiations of the insurance contracts.
1. Implemented a weekly operating performance report and a monthly financial performance report to allow the company to take rapid actions.
2. Improved monthly business cash flow by 50% on average.
3. Successfully steered the business through COVID.
4. Exceeded client’s revenue targets year over year for the last three years.
The client has multiple offices in North Texas and employs 20 internal medicine physicians in the group.
Client had undergone significant challenges with their previous RCM company and the RCM company left them shorthanded without a transition plan.
1. Unbilled claims worth $2.35m
2. Unposted ERAs for 9 months
3. Credentialing Issues
Claros implemented a two-pronged strategy:
1. Made sure that current claims were processed correctly and timely.
2. Old backlog was worked on.
Claros also implemented a better workflow for their internal processes and created efficiencies in the EMR system.
1. Improved the monthly collections by 33%. Reduced their outsourced RCM Cost by $200k over 18 months.
2. Days Accounts Receivables were greater than 180 days reduced to less than 5% – industry best standards.
3. Reduced DSO (Days Sales Outstanding) to less than 27 days, surpassing industry best standards.
4. Created a monthly performance reporting system for improved financial management and visibility of the practice.
5. Reduced total cost of engagement by 25% vis-à-vis previous RCM company.
6. Increased their business scope by helping them implement an in-house lab, thereby increasing revenue by 7%.
The client has various offices around the Midwest with a group of ten providers. The client has been in business for ten plus years.
Client identified issues in their RCM, Accounting, and business short-term strategy.
1. Created an in-house training system to train employees on the EMR system and the internal processes to better manage the outflow.
2. Switched from an in-house accounting system to a web-based solution.
1. Reconciled the financial accounts on the accounting system and set up monthly reporting for the client.
2. Improved monthly business cash flow by 25% on average.
3. Grew the business from 3 locations in Michigan to 6 locations in 3 different states.
The client has two locations and three providers in the group. The client is based in the Northeast and has been in business for more than 15 years.
Client had issues in their claims collections and financials.
1. COVID had significantly impacted cash flow for the client.
2. Lower patient visits post COVID impacted business.
3. Multiple loans/leases delinquent.
1. Restructured the business financially.
2. Out-sourced the accounting and tax preparation for the business.
3. Worked with multiple financial lenders to reach a settlement.
4. Took advantage of Federal programs (post COVID) to provide cash in the business.
5. Worked on claims collections to collect outstanding insurance balances.
1. Settled outstanding obligations with the loan processed and saved the business an overall cash of $175k (10% of total obligations).
2. Provided financial stability to the business.
3. Worked with insurance payers to get adjudication and payments on the outstanding claims from the last 2 years, thereby adding additional $150K in revenue.
Contact Claros today to meet your goals and grow your practice.
Copyright © 2024 Claros. All rights reserved.