CASE STUDY

Major Research Hospital Settles 55,000 Invoices and $15 Million in Outstanding Credit Balance With Billing Specialists

Our client is a major research hospital in California who reached out to us for help with two separate issues in their billing process—a backlog of 55,000 credit balance invoices, as well as 300,000 unposted payments.

Backlogged Medical Billing Threw Off The Hospital’s Balance Sheet

The hospital needed to clear the backlog of invoices as soon as possible to avoid any possible audits, while still maintaining a healthy rapport with their patients. The backlog included invoices from every specialty, making the overall process even more complicated for the hospital billing employees.

With over 300,000 payments that needed to be posted, errors became inevitable during the billing process. This resulted in an extensive amount of revenue cycle issues: understated accounts receivables, increased denials, false credits, and inaccurate patient statements. These problems increased the credit balance backlog, which further delayed and skewed the hospital’s balance sheet.

Infinx Specialists Chosen To Provide Medical Billing Support

While the hospital was transitioning informational systems from GE Centricity to EPIC, revenue cycle issues also needed to be resolved. The hospital decided to bring on Infinx for a numerous amount of billing services, including direct support with invoices and credit balance.

Billing Specialists Resolve The Outstanding Credit Balance Invoices

Our billing specialists evaluated the project, and based on the volume and nature of the invoices, proposed a detailed plan to solve the problem within a 15 to 17 month timeframe. A team of six to nine credit balance specialists was deployed to work with the client for the duration of the project.

Our experts were able to clean the entire backlog of invoices within 15 months. Within this timeframe, they analyzed the credit accounts, identified the exact reason for the credit, posted transactions to clean incorrect adjustments and write-offs, identified appropriate refund amounts, and created refund packets. Their efforts reduced the organization’s exposure to legal risks and saved the hospital’s billing team a significant amount of time.

Payment Postings Resolved During The Transition To EPIC System

To address the payment posting challenge, we formed a team to evaluate, manage and resolve the ongoing payment posting process. All of this had to be completed during the transition from GE Centricity to EPIC, which required an additional layer of caution about the process organization.

  • Our posting team worked an average of 10 hours a day as well as weekends to clean up the backlog and get caught up to within the current six months of bills.
  • We provided 24/7 staffing with complete support to ensure each payment was appropriately posted within both systems.
  • Our team manually reviewed a staggering amount of Electronic Remittance Advice (ERA) files to find and calculate the total payments for accounts that belonged to EPIC and those that were GE Centricity’s.

Positive ROI With Significant Revenue Cycle Backlog Cleared

We successfully resolved 55,000 credit balance invoices in 15 months and 300,000 late payment postings in 6 months. With two major projects completed, the hospital realized the positive return on investment (ROI) with a partner like Infinx.

Our experience across the revenue cycle allowed us to clean up both credit balance and payment posting backlogs. Our team of specialists enabled the hospital to resolve these two issues without needing to hire or train any additional staff. Their management team was thrilled with the outcome and the employees were delighted to not have to work overtime and weekends.

Infinx Engaged To Work Down Outstanding Accounts Receivable

Following this successful project, we were engaged to work down their aging accounts receivables. As we do this, our teams have been leveraging our proprietary technology to optimize A/R workflows. We look forward to providing a future update.

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