A Collaboration of ENT Practice Groups with Multiple Practice Management Systems
Client Background
This Southeast client is a collaboration of four ENT Physician Groups that treat over 20,000 patients a year. They currently have 14 combined locations, providing comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, and respiratory systems.
Challenges
The client sought to realize operational savings and increased payor contract rates that could be accomplished with the formation of a larger multi-practice organization. The individual practice groups, however, also desired to maintain their business autonomy and to continue using their existing Practice Management (PM) systems.
In order to accomplish these goals, and be prepared for anticipated future growth, the client needed an automated solution to process co-mingled payments submitted from different clearinghouse accounts and multiple Practice Management (PM) systems.
Maintaining cash flow and creating efficient AR processes in this new business environment was also a major concern.
The Solution
- For the individual Practice Groups to maintain their autonomy and operate under a single tax ID, the use of ReMedics’ Single Cash Management Solution was proposed. Proprietary software technology was put in place to accurately capture all claim, remittance, and bank reconciliation data for each PM system and clearinghouse. This also included capturing all lockbox correspondence.
- Daily ANSI 835 files are received, ingested, and matched against corresponding claim feeds for data splitting and validation (scrubbing) utilizing artificial intelligence (AI) business logic.
- In addition, bank BAI files (daily deposit register) are captured and utilized for internal Check Matching where batches received from the bank are matched and reconciled against the corresponding bank deposits. Correspondence received from bank lockbox(es) are auto-indexed by ReMedics for efficient retrieval, exception work-listing, and account follow-up.
The Results
As a result of ReMedics workflow automation processes, systems integration and improved data quality, the client is realizing consistent cash flow, accurate financial reporting, and efficient funds distribution for each group.
Where EDI payments from multiple divisions exist within a single check or batch, the system automatically splits corresponding payment and denial data into the appropriate EMR/PM system.
For unmatched and unidentified transactions, ReMedics provides the client with account level work-lists and corresponding reports that provides additional visibility to missing and/or unallocated funds for complete audit and tracking of bank deposits. Electronic work queues are updated daily and sent to a client-defined distribution list.
With paper-based remittances, ReMedics performs all of the necessary data conversion of payments and denials/zero-pays. Remittance files are separated by each Business Unit/Division, then transmitted to the client via ANSI 835 v5010 with associated reports.
All processed documents, including correspondence, are provided to the client in a ReMedics hosted content management system for archival and inquiry purposes. This helps improve customer service, provides for efficient secondary billing, and assists AR collections and follow up activities.
Positioned for Growth
With ReMedics services and technology, this growing practice can quickly onboard new business units while maintaining their autonomy — and the use of multiple practice management systems. Using a Single Cash Management Solution, future additions to the group can quickly be added to existing payment processing workflows. When business needs change, ReMedics can help the organization transition to a common platform through a planned systems migration.
Download this Case Study here.
About ReMedics, LLC
ReMedics’ Business Process Outsourcing (BPO) services, combined with workflow automation and document management technology, offers a fully outsourced payment processing solution that significantly helps to facilitate practice aggregation business models. By leveraging a proprietary Single Cash Management Solution, ReMedics manages the data capture, parsing, batch balancing, data validation, and bank reconciliation for all types of remittance processing. Based in Northeast Ohio, all of our services are performed in the United States.
Working with ReMedics
Let’s talk about how we can deliver operational savings and revenue cycle improvement to your organization. Contact Us today to get started.