ATOM’s End-to-End Solution Enables Gastroenterology Client to Achieve Claims Rejections of Less Than 1%

ATOM’s End-to-End Solution Enables Gastroenterology Client to Achieve Claims Rejections of Less Than 1%

The Client 

The client is a sought-after gastroenterology service based out of New York who offers diagnosis and treatment for the complete gamut of conditions of the gastrointestinal tract including complex conditions. They are known for their top-notch medical practitioners and specialists, state-of-the-art facility and use of latest technology, groundbreaking techniques and next-gen approaches to offer personalized and high-quality care to each and every patient. 

Client Challenges and Requirements 

The client was facing significant challenges in billing, claim submissions and collections. The complexity in coding resulted in inaccurate billing. Due to inaccurate billing and fractures in the reporting process, they were facing high denials of claims. Additionally, there were unable to make timely and accurate claims submissions, which was severely impacting their cash flows. Given the high volume of patients, the liquidity and revenue cycle took a severe blow. 

They required a holistic, hassle-free and effective solution to ensure accurate and timely billing and submissions that would improve transparency and their monthly collections. They wanted an RCM solution that would enable them to focus on providing high-quality care and seamless experiences to their patients. 

ATOM’s Highly Specialized and Tailored Solution

Having deep-dived and analyzed the client’s core challenges, context and requirements, our team of experts at ATOM crafted a scalable, highly tailored and cohesive strategic plan to enable the client to rectify the issues, maximize reimbursements and maintain positive cash flows.

  • We closely monitored and followed up on the credential process to find gaps and weaknesses in the process and helped the client to effectively resolve these. 
  • We developed a high-level reporting structure to monitor all the activities and fix them in a timely manner with the help of cutting-edge tech solutions. This enabled them helped to speed up claim submissions and thus, quicken collections.
  • Based on requirements, we enabled them to submit various reports in a timely fashion. 

Achievements

ATOM’s highly tailored, strategic plan and solutions enabled the client to achieve the following 

  • Improved accuracy in billing: Our quality process empowered the client to enhance the accuracy in the billing process.
  • Minimal Rejections: The enhanced accuracy and efficiency in billing enabled the client to minimize rejections. The rejections were less than 1%.
  • Zero eligibility denials: The client achieved zero denials permeating from non-eligibility. 
  • Increased monthly collection: The improved efficiency and effectiveness in the submissions and billing processes helped the client to increase their monthly collections by 10%. 
  • Shortened AR days: The client reduced their AR (Accounts Receivable) days reduced from 45 days to 28 within a short span of time. 

Results

The improvements in revenues and cash flow and enhanced transparency in tracking claims have empowered the client to focus on what matters most to a sought-after gastroenterology practice – delivering best quality patient services and care and crafting frictionless experiences for each patient. The client expressed utmost satisfaction with ATOM’s services that they referred multiple clients to help us grow our business. 

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