26 Year Partnership Yields Fully Optimized Revenue Cycle, Outstanding ROI

Client

Clinical Pathology Associates, PC, Waterloo, Iowa

Major pathology medical group

Critical Issues

• Internal coding and billing processes were inefficient and errors were negatively impacting the practice’s bottom line. Payors were incorrectly denying claims and reimbursing at lower rates.
• Revenue cycle expertise was needed to improve coding and billing as well as to guide the practice toward streamlining processes to ensure revenue optimization.
• The pathology group wanted an outsourced solution that provided highly-personalized service, in-depth industry knowledge and a simplified fee structure.

Solution

• Clinical Pathology Associates chose to partner with Professional Management, Inc. (PMI) based on the company’s pathology expertise and reputation for highly-attentive customer service and flat fee pricing model.
• First, PMI audited the practice’s revenue cycle operations to identify opportunities for improvement and develop a benchmark from which to measure progress.
• Immediately, PMI took a hands-on approach to manage difficult claims in order to accelerate turnaround times.
• PMI worked closely with the practice’s internal resources to provide ongoing support and expertise. The company also continuously reviewed the group’s claims for coding accuracy in order to ensure optimized reimbursement.
• PMI also provided advisory services and training to help the practice plan for the transition to ICD-10.

Results

• 90 percent of the practice’s accounts receivables were closed within 90 days. In fact, on average, more than 70 percent were paid in less than 30 days.
• Coding accuracy as well as revenue cycle efficiency improved significantly which enhanced the practice’s bottom line.
• The partnership has been so successful that it has continued for 26 years. In addition to the outstanding financial results, the practice credits PMI’s unwavering personalized service and high-level of industry expertise as additional benefits.