AI Powered Precision Medicine Facility Automates Medical Billing

Company Profile:

INDUSTRY: HealthTech

SOLUTION(S): RCM

LOCATION: North Carolina, USA

EMPLOYEES: 100+

Challenges:

  • Streamline medical billing for revenue cycle management.
  • Implement a complete billing solution for claim management, payment collection and patient statements
  • Manage the entire claim lifecycle and ERAs
  • Handle claim rejections and denials
  • Support Subscription based payment management with installment- based payments for patients.
  • Integrate with a payment gateway to enhance payment collection efficiency.
  • Ensure staff are trained to use the new system effectively for a successful transition.

Solution Highlights:

  • Configured automated workflows for efficient processing of  primary and secondary insurance claims.
  • Enabled automated posting of claim payments to reduce manual errors and improve accuracy.
  • Implemented claim modifiers for precise adjustments.
  • Developed detailed reports for claims by status, payer, and aging to enhance financial oversight.
  • Implemented accurate calculations for patient financial responsibilities.
  • Set up processes for automated and manual patient payment collection.
  • Created and generated patient statement templates and set up batch processes for statement file generation.
  • Integrated with a credit card processor compatible with Salesforce for seamless payment processing.

Results:

  • Enhanced Efficiency: Reduced claim processing time by 40% and payment workflows by 35%, resulting in faster revenue realization and decreased overhead.​
  • Improved Accuracy: Achieved a 25% reduction in manual errors and discrepancies.​
  • Better Financial Management: Enhanced financial transparency with a 30% increase in reporting accuracy and 20% better insights.​
  • Seamless Transition: Achieved a 95% user adoption rate with minimal disruption, reducing the transition period by 50% compared to previous implementations.​
  • Ongoing Support: The 60-day warranty addressed and resolved 90% of post-implementation issues, ensuring system stability and user confidence.​

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