Case Study:

How IRCMS Helped One Client Double their Cash Receipts

Revenue Cycle Management (RCM) services are crucial to a business’s profitability. It involves everything from medical billing to claim submissions, and it needs to be carefully managed for a practice to receive timely payments. Such was the case with the Client, an organization that approached IRCMS when they needed a biller. After several months, the partnership deepened, and IRCMS took over all services and billing for Client. Through teamwork and perseverance on both ends, IRCMS was able to recover nearly $450,000 in unbilled revenue over two months, effectively doubling their cash receipts. And it all stemmed from integrating RCM services tailored to the Client’s unique needs.

The Client is a non-profit organization that runs programs for individuals with disabilities, providing early intervention programs, child development centers, and day programs for adults. Working with IRCMS meant turning their attention to RCM services and streamlining their processes. At first, they successfully billed some services; however, they soon discovered they had issues with their billing system. This led to a significant number of claims being denied.

Fortunately, IRCMS has proven strategies to rectify these challenges. The first step was to ensure data collection was concise and correct, which required coordination between IRCMS’s billers and the Client’s claims processors. Once the data was reliable, IRCMS started to submit the claims with the utmost accuracy and completeness, reducing claim denials by identifying and correcting errors.

The second step was to identify why some claims were still being denied. After research, IRCMS found they were facing issues with time limits. Medicare, Medicaid, and private insurance companies have specific time limits for a medical facility to submit claims which the Client was missing. IRCMS implemented software to track the progress of a claim from inception. This helped prioritize claims to ensure meeting deadlines.

The final step was to address denied claims. Denied claims require significant manual work. But, with the knowledge of the Client’s claims and processes, IRCMS quickly detected a pattern for the denied claims, allowing IRCMS’s billers to work on these claims more efficiently. This resulted in a faster turnaround for resubmitting the claims and receiving payment.

When the Client approached IRCMS about RCM services, they needed help with one of their billing aspects. IRCMS’s implementation of comprehensive data collection, prompt submission and resubmission of claims, and timely corrections led to a successful collaboration, nearly doubling the Client’s cash receipts. The Client now trusts IRCMS with all their billing, and the partnership continues to grow. If intently focused, every provider can achieve immense success through RCM optimization.

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