CASE STUDY 4
INSURANCE DISCOVERY
Client:
RCM firm working with a network of hospitals, clinics and home care services in 5 mid-western states
Challenges:
- Inefficient and expensive process for contacting patients to capture insurance information
- Shortage of resources to review entirety of benefits information to enter and submit claims in a timely manner
Solutions:
- Daily process validates accounts for insurance coverage, including hard to locate blue plans and Amerigroup
- Customized output file captures relevant policy information required to enter and submit claims
Results:
- 30% average success rate over a 6 month program
- ROI includes 2.5X return on spend along with more efficient use of resources