Improving Revenue for Island Regional Hospital Through End-to-End RCM Services
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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.
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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.
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- 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
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Enhanced staff efficiency
by
40%
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Average A/R days were reduced
by
30%
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