The Client
A New York-based healthcare provider specializing in spine medicine and surgery. The client delivers comprehensive patient care and is dedicated to optimizing healthcare outcomes through efficient medical practices.
The Requirement
The client required robust Revenue Cycle Management (RCM) support. This included managing accounts receivable correspondence, reviewing settlement offers, and handling denial histories, all with a tight 24-hour turnaround time. They also needed transparent communication, consistent reporting, and real-time support via Microsoft Teams.
The Challenges
- Ensuring sufficient resource allocation and shift planning for time-sensitive correspondence and offer reviews.
- Onboard and train staff in client-specific systems and protocols.
- Maintaining seamless communication via Microsoft Teams and preparing detailed daily and weekly reports.
Our Solution
We implemented a structured and efficient RCM workflow with the following approach:
- Proactive Staffing: Scaled the team from 1 to 3 FTEs to meet daily workload requirements.
- Quality Training: Delivered focused training to ensure team readiness in handling denials, offer reviews, and documentation.
- Responsive Communication: Maintained real-time availability on Microsoft Teams and delivered structured reports for calls and reviews.
- Daily allocation and thorough review of accounts from correspondence.
- 24-hour turnaround for offer validations and escalations.
- Denial and discrepancy management through EOB analysis and appropriate resolution (appeal/resubmission).
- Document all actions and timely escalations when needed.
- Use tools like DR Chrono, UHC-Oxford, Availity, Medicare, and other payer portals to manage claims efficiently.
The Outcome
Our solution delivered measurable business outcomes, including:
- Faster offer processing and AR management, improving cash flow.
- Reduced claim rejections due to proactive denial handling.
- Increased revenue recovery through streamlined offer validation and follow-ups.
- Improved communication and transparency with daily and weekly reporting.
- Lower operational costs through optimized workflows.
- A stronger, more responsive client relationship driven by consistent results.
Outsource Revenue Cycle Management Services to Flatworld Solutions
Looking for a reliable partner to manage your revenue cycle processes? Flatworld Solutions offers efficient, accurate, and scalable RCM services tailored to healthcare providers. We help maximize collections, reduce denial rates, and improve financial performance with rapid turnaround times and strong client communication.
Let us help you strengthen your revenue stream with expert RCM solutions.!
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USA
Flatworld Solutions
116 Village Blvd, Suite 200, Princeton, NJ 08540
PHILIPPINES
Aeon Towers, J.P. Laurel Avenue, Bajada, Davao 8000
KSS Building, Buhangin Road Cor Olive Street, Davao City 8000
INDIA
Survey No.11, 3rd Floor, Indraprastha, Gubbi Cross, 81,
Hennur Bagalur Main Rd, Kuvempu Layout, Kothanur, Bengaluru, Karnataka 560077
