Old Meets New: How RCM Adoption Increased Transparency and Expedited Payments
Meet Dr. Siegel
Dr. Siegel, on the other hand, had recently left a large practice in Chicago and started a new practice in Tampa in 2017. Aptly named after his mission to deliver modern patient care, he built Modern Foot & Ankle with a strong IT infrastructure and quickly amassed a large clientele.
Meet Dr. Zuri
Dr. Zuri worked at All Podiatry Group (APG), a long-established podiatry practice, which had been seeing patients in Tampa, FL for over 40 years. All Podiatry Group kept two doctors busy with 40 patients a day across two different offices.
About the Practice
All Podiatry Group has been a long-standing podiatry practice in Tampa, FL for over forty years. Modern Foot & Ankle, on the other hand, was founded in 2017 by Dr. Adam Siegel and Lindsay Siegel. Dr. Siegel was an associate of a large Chicago practice and moved to Tampa, where he built a new practice, Modern Foot & Ankle, with the idea of delivering modern patient care.
The two practices merged and synchronized their clinical workflows with their EHR, DrChrono, which was more scalable enabling further growth. They subsequently needed to evaluate how they could optimize the billing side of their practice.
The Business Challenge
As a new practice, Modern Foot & Ankle could manage their low volume of patient claims in-house.
Typically, claims were paid within two weeks of the appointment. DrChrono’s billing software let Dr. Siegel easily submit claims, automatically post payments, and see live-status updates on any claim. As a single provider practice, managing his own billing was the obvious choice.
That all changed when Modern Foot & Ankle merged, adding two more providers. Dr. Siegel noticed a discrepancy in collections between Modern Foot & Ankle and the higher-volume All Podiatry Group almost immediately after the merge.
At the time of the merge, All Podiatry Group was using a local vendor. This meant their claims weren’t paid for one to two months after the appointment.
The vendor required All Podiatry Group to fax each claim over individually. No insight was given to the status of claims, and the practice couldn’t get insight into an individual claim.
Electronic EOBs (ERAs) needed to be faxed over and inputted through MYSis, a billing software. This meant All Podiatry Group staff had to do the manual coding and inputting of the required information. Then they would wait for the billing company to look over the claims and submit them to the designated insurance company. While this system allowed for real-time payment insights, claim submission performance could only be seen in the end of the month report. Despite the real-time payment info, the system was clunky and the information passed through too many hands, increasing risks of mistakes.
Despite their success, Dr. Siegel wanted to optimize claim management for their joint practice. He wanted RCM services that would ensure equal or greater performance with less internal demand on the practice.
Solution
Dr. Siegel had been familiar with the RCM services DrChrono provided since 2017 and now that All Podiatry Group had fully integrated DrChrono EHR, they saw the transition to the RCM as the next logical step.
Upon adopting DrChrono’s RCM services, the practice noticed a positive difference within the first month. In addition to saving time for employees within the practice, DrChrono provided the practice with:
- Increased transparency
- Faster payments
- Automated workflows
- Reduction in overhead
- Reduction of costly mistakes
Switching to DrChrono RCM quickly delivered more efficient workflows and an increase in revenue for the practice.
Workflow Automation
With DrChrono, administrative staff no longer had to spend time communicating billing information to outside services.
Electronic EOBs were posted directly into DrChrono by the insurance company, eliminating the middleman and reducing the chance for input errors.
The staff had more time for other tasks, since faxing claims and receiving responses was fully automated through DrChrono. A dedicated DrChrono team carefully verified every claim. With fewer input steps, human error was minimized. This meant fewer costly mistakes and less time spent by staff on iterative manual inputs.
The joint practice streamlined their entire workflow to fit their specific needs. They customized billing profiles, meaning all CPT, ICD-10 codes, and modifiers were automatically attached to the patient encounter when the note was created.
The claim submission process was sped up by this auto-population. The automatic entry of patient information and codes associated with procedures saved the practice time while still maintaining their active role in the billing.
Instead of inputting or faxing claims, or hiring additional staff for this time-consuming task, the practice could focus on providing care.
Greater Transparency
Providers were able to receive and respond to messages regarding specific claims within DrChrono. This meant outlier questions would not disrupt the existing workflow. This direct line of communication between billers and individual providers meant that both practices received real-time feedback. This streamlined feedback system for claim improvements ensured the practice would receive full, on-time payments.
Dr. Siegel and Dr. Zuri were able to see exactly how and why an individual claim was not paid immediately, allowing them to make modifications as needed. With DrChrono, they were able to see the status of every single claim, including where it was in the process.
No more surprises, no more waiting until the end of the month for a clunky, batched claims report.
Faster Payment
With their dedicated DrChrono team reviewing claims, the practice’s clean-claim rate climbed to over 96%.
The majority of their claims were paid within 30 days, spending an average of just 21 days in accounts receivable. The direct integration between DrChrono and the Clearinghouse meant that providers could directly submit claims to the insurance companies. This meant the claims didn’t have to change hands numerous times prior to the final submission, which cut way back on errors and delays. With DrChrono only 13% of AR reached to be over 90 days old.
In the first year, Dr. Siegel noted that his groups saw a 10% increase in their overall collections with DrChrono. In the second year, they saw an increase of 19% in payments processed by insurance, compared to the previous time period.
Conclusion
All Podiatry Group and Modern Foot & Ankle now manage their claims efficiently through a clear and automated process. There’s no longer any time spent on a middleman, and less time is spent waiting on insurance companies.
With DrChrono, the claims process is predictable, malleable, and tracked in real-time. The joint practice can finally spend more time focusing on patients and delivering care, and less time on the tedious, iterative billing processes they muscled through before.