Case Study on Full Service Billing for an Urgent Care Practice

The Customer:

Our customer's clinic started in the year 2005, in response to the growing need for high quality and convenient medical care in a warm, friendly environment. Some of their treatments include:

• Colds, coughs and flu
• Cuts and bruises
• Ear aches and infections
• Broken bones and fractures
• Burns, rashes and bites
• Sprains and strains
• Vomiting and diarrhoea
• Allergies and asthma

They have 1 Doctor who works on a full time basis and 2 Doctors who work on a part time basis.

The Project:

The customer's accounts receivables was getting older and they didn't have the time or resources to handle them. The customer finally approached Outsource2india in September 2007 when all their in-house efforts failed to manage their A/R in a cost effective manner. The customer also faced problems in billing like:

• The billing was not completed within 24 hours
• Steep decrease in collections
• Inconsistent cash flow

The customer wanted to hand over full service billing to Outsource2india in 2 months if they were satisfied with our AR follow-up capabilities.

The following was their AR structure before Outsource2india was contacted.

The Solution

• The customer signed up in just 1 month for full service billing after gaining confidence in the way Outsource2india did AR follow-ups with insurance companies
• A dedicated account manager and team were deputed to handle the account
• The team consisted of full time employees for medical billing, medical coding and an AR specialist
• Outsource2india developed a medical billing process and an AR process to make sure that billing takes place within 24 hours after the doctor has seen the patient
• Outsource2india followed-up on denied, underpaid and unpaid claims
• Issues with insurance companies were addressed and resolved quickly
• Outsource2india maintained a knowledge base of issues and solutions and documented them in a business process manual

The Results

By outsourcing medical billing to Outsource2india, the customer was able to:

• Witness that the average AR days were brought down from 34 to 23 days within 6 months
• Witness that the collection percentage increased from 53% to 61% within 6 months
• Experience significant improvement in the cash flow as a result of an increase in collection ratios
• Concentrate on patient care and see more patients, with the availability of more time and a clutter-free office
• Enable employees to focus on core business aspects, instead of billing related tasks
• Eliminate fluctuations associated with backlogged claims and employee turnover
• Increase operating efficiency and reduce administrative costs

The following statistics will show how Outsource2india made tremendous improvements in increasing collections and making the cash flow consistent for the customer.

These numbers show that:

• In the 0-30 days bucket, the percentage gradually increases towards the end
• In the 91-120 days bucket, the percentage gradually decreases towards the end
• In the 120+ bucket, the percentage tremendously decreases towards the end

The collections percentage by end of November 2008 is 65% as against 53% before Outsource2india started providing the service.

The average AR days by end of November 2008 are 20 days as against 34 days before Outsource2india started providing the service.