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