Case Study:

Integrated RCM Services: A Case Study of a Successful Decrease in AR

For any healthcare organization, revenue cycle management (RCM) is a critical aspect of financial stability. However, managing AR (accounts receivable) can be an overwhelming and daunting task. Every healthcare organization needs a robust RCM system to ensure they collect revenue efficiently and effectively. In April 2023, a Client had over $277,000 in outstanding AR from 2022 and older. They reached out to IRCMS for assistance with their AR challenges.

IRCMS began by addressing the root causes of the problem including a lack of documentation, delayed filing, and coding errors. IRCMS worked with the Client’s staff to resolve these issues, which resulted in a smoother billing process and a decrease in the number of denied claims.

The Client’s revenue cycle was hampered by the complexities in the policies of different insurance providers. In such situations, IRCMS – with its deep industry knowledge – took a multi-faceted approach to address the issues, including a comprehensive coding and compliance analysis, a real-time denial management program, timely follow-ups, and the implementation of efficiency-best practices.

In eight short months, the Client’s AR decreased by over $222,000, recovering $77,000 in payments and making long-overdue adjustments of $145,000 from relationships with commercial and managed care insurance plans. Medicaid was not included in the plan. The remaining amount reflects 90% to insurance that IRCMS is actively pursuing and 9% patient responsibility.

The decrease in AR allowed the Client to focus on patient care instead of spending time and resources on collecting payments and managing the billing cycle.

With its integrated approach, IRCMS helps healthcare organizations deal with challenges in their revenue cycle management effectively. We understand the complexities in the healthcare industry and the importance of addressing the root causes of AR challenges. By providing healthcare organizations with a multi-faceted approach to improving their revenue cycle management, IRCMS helps in the development of an efficient and effective billing process. If you are a CMO, CIO or CEO looking to enhance your healthcare organization’s RCM process, call IRCMS to discuss our comprehensive solution.

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