Claim payout dropping and accounts receivable piling up

Dr. Chester Miltenberger is a long practicing medical professional with almost three decades worth of experience and runs a large practice in Lake Mary, Florida. After having used a number of different approaches to handling billing at his practice, the doctor shifted focus to an internal biller and billing company. This, however, did not pan out either as this approach also turned out to be ineffective due to unresponsiveness on the biller’s part. With claim payout dropping and accounts receivable piling up, Dr. Miltenberger needed a solution  to increasing revenues fast. That is when he heard about WRS Health billing and revenue cycle management (RCM) services. The following explores the difficulties Dr. Miltenberger experienced and how WRS Health solved those issues.

Background

Dr. Chester Miltenberger is a practicing internal medicine physician with over 30 years’ experience in the business. Dr. Miltenberger graduated from the University of Florida medical school in 1981 and went on to complete both his internship and residency in internal medicine at the Shands Jacksonville Medical Center. Over the years, Dr. Miltenberger has moved around the state of Florida practicing medicine until he settled in what is now his primary focus, his internal medicine practice in Lake Mary, Florida. Currently employing six support staff and being the solo provider in his practice, Dr. Miltenberger is passionate about providing the best healthcare services to his patient and as such has invested significantly in transforming his practice into a superb healthcare facility. Dr. Miltenberger typically sees an average of 180 patients a week with a small fraction of those being new patients. Besides practicing medicine, Dr. Miltenberger is an avid swimmer.

Challenges and Solutions

Claims Denials

Claims reimbursements was one of the biggest challenges Dr. Miltenberger and his practice faced before adopting WRS Health billing solutions. Having tried an internal biller and a dedicated billing company, their claim denial rates simply refused to go down. Dr. Miltenberger elaborates, “Claims payments are the main source of income for my practice so when claims denials are high, it means our overall revenue suffers. This was the case for a number of years as health reforms took shape and the billing systems we were using just couldn’t keep up.” To make matters worse for the practice, having a billing system that was not fully integrated into their EMR meant there was great difficulty correlating patient information to find out how to fix denied claims.

WRS Health billing and revenue cycle management solutions focuses on claims payment maximization through a managed rules engine. Through this system, practices see some of the lowest claims denial rates in the industry, something that became a reality for Dr. Miltenberger after adopting the WRS Health billing and RCM solution. “One thing that has been the biggest source of delight to my practice and I has been the rate of denials. Previously the number was pretty high but I’m very pleased with the very low rate of denials we experience today as a result of using WRS Health. Our revenues have stabilized and even started to rise, billing has stopped being a pain and my staff are overall satisfied with how our billing system is now.”

Accounts Receivable

Following closely behind claims denials is accounts receivable. This is another area where Dr. Miltenberger’s practice was facing significant challenges before adopting WRS Health billing solutions. As is typical with any busy practice that sees upwards of a hundred patients a week, A/R tends to pile up over time as staff members become stretched and there isn’t sufficient time to follow up with all A/R items in a daily basis. This was the situation Dr. Miltenberger found his practice in, “It was a mess. We had accounts receivable piling up on a daily basis and I had to sit down for hours each week to follow up on each item and make sure it was actioned. This was a huge challenge especially because as A/R was not tracked, revenue were impacted as we were not getting paid on time. This mess is what influenced our decision to try out WRS Health and see how their A/R management solution could assist us.”

WRS Health Revenue Cycle Management is an integrated billing and financial solution that helps practices manage their A/R in an effective and efficient manner. Reducing the amount of manual work that needs to be done to deal with A/R. WRS Health RCM helps automate the entire accounts receivable process so you don’t need to worry about going through each item one at a time. Once Dr. Miltenberger had WRS Health RCM in place, A/R issues steadily declined to normalize at a predictable and acceptable level. “With WRS Health RCM, we’ve really seen a difference in how our accounts receivables are being managed,” said Dr. Miltenberger. “While previously I had to spend hours working through A/R each week, now my time commitment is significantly reduced and it’s now even easier to see how my practice is doing financially through the integrated dashboard available in the WRS Health system. I’m very pleased with where things are now.”

Performance Reviews

“Over the years when we were using other billing solutions, it was very difficult, in fact close to impossible, to know from those systems how we were faring as a practice financially. The companies we were using also did not offer us any additional services in this regard so we mostly had to figure out how we were doing and how to improve things ourselves.” This challenge, which Dr. Miltenberger describes, was one of the things that made it hard for him to stick with the other provider’s solutions. They may have been okay and functioned as described but he always felt that there was more that could be offered. Dr. Miltenberger was in the process of growing his practice and therefore needed a billing solution aligned with these goals. A solution that would help him see were his practice was and what he could do to get it to where he wanted it to be.

One of the unique things that WRS Health offers within its billing and RCM solutions is regular review meetings between financial experts from WRS Health and the practice. This emerged as a need for most practices as most simply went from month to month just cruising along without an inkling of what they could be doing better to improve their revenues. After signing up with WRS Health, on average about one review meeting a month is conducted with Dr. Miltenberger or his staff to look at how the practice is doing and where there is room for improvement. “This is one of the things I positively love about WRS Health, the monthly status review documents they send me that give me insight into how my practice is operating. These are followed up with a meeting where we discuss issues that can be tackled in the following month, something that has really helped me grow my practice and revenues over time.”

Specialty-specific Billing

As a practice focused on internal medicine, Dr. Miltenberger needed a billing solution that would be specialty-specific, thus making their work as a practice easier. Previous solutions used at the practice were more or less generic and this made it difficult to adapt the system to the specific needs of the practice. “One thing that I wished for in a billing solution was to find one that was specific to my specialty of internal medicine,” Dr. Miltenberger reminisced. “We had used other systems but they were all generic so we found ourselves having to adapt the system to our internal medicine needs, something that slowed us down and made our work more difficult rather than easier.”

WRS Health billing and RCM solution is designed to cater to specialty-specific needs of doctors such as Dr. Miltenberger. WRS Health is designed in this way because it’s obvious that specialty practices have unique needs that need to be addressed in a specific manner. Through implementing an internal medicine specific billing system at Dr. Miltenberger’s practice, WRS Health was able to reduce the amount of time and effort required to handle billing for the practice. “This was a stroke of luck on our part,” says Dr. Miltenberger, “as were just didn’t know how we were going to keep using platforms and solutions not built for our practice specialty. I was pleasantly surprised to find the templates and other modules were designed for internists such as myself, something that has saved me a ton of time and effort.”

Outcomes and Impact

Before signing up with WRS Health, Dr. Miltenberger had used both an in-house biller and a billing company, both of which did not address sufficiently his practice’s needs. By adopting WRS Health Billing and RCM solution, these were to gains Dr. Miltenberger was able to accrue at his practice:

• Claim denial rates fell substantially owing to the better pre-verification offered by the automated rules engine within the WRS Health billing system.
• His practice’s accounts receivable have also dropped significantly with more timely payments being made and within a more manageable workflow.
• Through the monthly reviews Dr. Miltenberger has with WRS Health staff, he has been able to plug revenue leaks and also discover new ways of increasing his practice revenues –which have increased 5 fold since the adoption of WRS Health billing services!
• The practice’s entire workflow has become more streamlined and efficient, which has freed up his staff to serve customers better and given Dr. Miltenberger the pause he required to focus more on his life outside of medicine.