In working with the client, CSI discovered a number of areas that needed revamping.  Here are the specific challenges that the organization faced, paired with CSI’s suggested solutions, and the outcome that was achieved:

THE CHALLENGES

  • Professionalism of the staff
  • Overall patient satisfaction
  • Billing errors and deficiencies
  • Missed and delayed insurance reimbursements
  • Call abandonment
  • 7 month backlog: claims submissions, appeals, ledger postings, contractual allowance reductions, and patient refunds
  • Accounting errors
  • Disorganized document retention
  • Legal liability from lack of attention to HIPAA, PHI, and credit reporting
  • Reducing overall expenses associated with current operation

 

OUR SOLUTIONS

  • Worked with client to develop customized processes, procedures and operational strategies to maximize cost savings and efficiencies
  • Created customized training program focused on patient satisfaction and overall professionalism
  • Established an integrated solution and direct access into client host system to provide real-time access to documentation and accounting corrections and details
  • Implemented an electronic document management system providing immediate access to all clinical, accounting, and legal documents
  • Streamlined excessive IVR menu options to shorten steps needed to interact with a live agent
  • Instituted a first call resolution process
  • Implemented a HIPPA certification program including stringent qualification standards exceeding both individual State and Federal compliance guidelines
  • Initiated direct access to insurance providers databases and services to streamline the medical payment process

 

THE RESULTS

  • Success in delivering on the client’s challenges resulted in CSI handling all 15 client hospitals today
  • Reduced abandonment rate from over 20% to under 1%
  • Eliminated a 7 month backlog on claim submissions, appeals, ledger posting, contractual allowance resolutions, and patient refunds
  • Eliminated enterprise-wide liability tied to HIPPA and PHI compliance
  • Greatly reduced liability associated with inaccurate credit reporting
  • All client documents are now electronically processed, indexed and stored
  • Client staff has immediate, real time access to all documentation attached to patient accounts
  • CSI exceeded all of the client’s goals and did so in less time and with less staff than the client thought possible
  • Reduced staff from 75 agents to 18 (a 75% reduction), saving over $1.2 Million in operation expense annually
  • CSI process improvements prevent millions of dollars of revenue from being lost each year