The client is a large-sized mental health service organization spread across multiple locations in the US.
We started working for this organization in March 2021 for two of their locations. To begin with, we conducted an AR audit and analyzed the RCM strategy for the client to understand their workflow. In this process, we identified the following issues:
Our team implemented a robust process to ensure eligibility and benefits check 3 to 5 days before appointments. We optimized the eligibility process and reduced patients' medical record gaps.
We did RCA (Root Cause Analysis) and bifurcated payments: payer-wise, $ value wise, and other priority categories and started the posting activity.
We consolidated all the backlog payments to understand the non-posted payments pattern.
We worked on the denials by implementing a proper denial management process.