Client Overview:
A small behavioural health clinic in Texas offering mental health and substance abuse treatment services, facing a significant backlog of unpaid claims and delayed reimbursements.
Challenges Faced:
- A $1M AR backlog
- High rate of claim denials
- Aging claims leading to delays in payments and financial instability
PhysiAssist’s Plan of Action:
- Automated Claims Management: Deployed an automated claim management solution to address the backlog, enabling quicker submission and tracking of claims.
- Denial Management: Prioritized claims with high denial rates, addressing the underlying issues through proactive payer communication.
- Backlog Reduction: Focused resources on clearing the $2M backlog by systematically working
through old claims while keeping new claims flowing smoothly. - Integration with Payers: Integrated data from various payers into one unified dashboard, reducing delays and preventing information gaps.
Results:
- Cleared $1M backlog in 75 days
- Reduced AR Days from 90+ to under 40 days
- Increased cash flow through quicker claim approvals