Revenue Cyle Management
Autymate Statement Scrubber
Autymate helped us to identify, define, document, improve, integrate, and deliver all ecosystem procedural components in a single visually and operationally consumable web portal containing actional RCM KPI data.
The practice administrator of a southeastern primary care & multi-specialty group was searching for a way to stop the “ill-will” phone calls coming into their billing call center.
The calls were triggered by patients receiving an erroneous balance due on their statements because it did not reflect all payments made to the office. The practice needed an easier way to capture these unapplied credits before the statement files were transmitted to their statement service vendor.
There was an added concern for their ever-increasing monthly statement count. The opportunity to have light shed on the reasons for the escalating cost of statements was of great interest to them.
This clinic was operating on the Greenway Prime Suite EMR/PM system. The weakness of the system is its inability to keep patient payments and credits linked to the appropriate patient charges and balances. The billing team was required to run daily reports to identify patients with credits so that they could get them applied to balances before the statements ran each night. It was not only a daunting task but also an imperfect workflow causing statements to prematurely be released for mailing. This process typically took one staff member 30 to 45 minutes each day to perform. The phone call volume averaged over 240 per month (12 calls per day).
Similarly, the Prime Suite system does not offer an automated feature to prevent sending patient statements incessantly. The billing team relied upon a manual process to try to stay ahead of accounts that are aged and/or patients–particularly the uninsured–that were failing to pay their balances or maintain payment plans.
Utilizing the Statement Scrubber (the “Scrubber”) application, the practice was able to securely submit their statement file through the Scrubber on a bi-weekly basis for its automated previewing functions. Each incoming file was scrubbed for statements containing overstated balances. They were identified, suppressed, and reported back to the practice. The “clean” statements were then forwarded to the statement service provider for normal processing and delivery.
The Scrubber also identified a high volume of accounts that had aged beyond 120+ days. The suppression action was applied based on built-in Best Practice criteria while the less-aged accounts were allowed to pass through for mailing. The RCM director was able to access the Scrubber user portal to work through each of the outstanding balances using the sort & filter options provided. In addition, they were able to establish a “new normal” within their billing department using more manageable workflow processes.
▪ 0% reduction in statement volume and cost compared to same time period in previous year
▪ Over $11,725.00 saved in statement cost in 8 months
▪ A near complete elimination of incoming calls relating to unapplied credits
▪ Earlier capture of aging balances & repetitious billing
▪ Bad debt reduction associated with untimely claim-files or appeals
▪ Additional revenue leaks & opportunities identified i.e. copay shortages & outdated payment plans