Improving Revenue for Island Regional Hospital Through End-to-End RCM Services
The Client
The client is a regional hospital located on an island facing financial challenges.
Business Challenges
The hospital had been struggling to maintain a consistent revenue stream, with monthly earnings plateauing at $4.5 million.
Inefficient Account Receivables Management: The hospital lacked a streamlined process for managing accounts receivables, leading to delays and revenue leakage.
Limited Understanding of Payor Framework: The hospital’s staff had a limited understanding of the complex payor landscape, resulting in missed opportunities for revenue maximization.
Manual Processes: The hospital heavily relied on manual processes for billing and claims, which were prone to errors and inefficiencies.
Solutions Delivered
We sat down with the team to review the shortcomings in their current system and examine where we could effectively work to improve revenues and processes.
- Implementation of HealthX – Jindal Healthcare’s Proprietary Software:
Jindal Healthcare deployed their proprietary software, HealthX, which leverages advanced machine learning algorithms to streamline the entire revenue cycle management process.
- Data-Driven Insights:
HealthX provided actionable insights by analyzing historical data, enabling the hospital to identify trends, payer behavior, and areas for improvement. - Process Optimization:
Jindal Healthcare collaborated closely with the hospital’s staff and our offshore team to re-engineer their accounts receivables process. This involved:
Defining clear workflows for billing, claims submission, and follow-up.
Automating routine tasks to reduce manual intervention.
Implementing checks and balances to minimize errors.
- Staff Training and Development:
Jindal Healthcare conducted extensive training programs to upskill their own staff keeping in mind the revenue mix for the hospital and with a focus on payor dynamics, coding compliance, and claims processing.
- Payor Framework Understanding:
Jindal Healthcare provided the hospital with a comprehensive overview of the payor landscape, including payer behavior, reimbursement trends, and negotiation strategies.
Outcomes
Enhanced staff efficiency
by
40%
Average A/R days were reduced
by
30%
