Days to A/R can be a make-or-break metric for private practices looking to grow or merely stay afloat. By looking at billing performance metrics, Metis Advisors can help physicians increase revenue. This is especially true in the midst of a global pandemic! Read below how Metis increased performance for a successful gastroenterology group in the Rio Grande area of Texas.
49% of medical practices say their time in A/R increased in 2021.
MGMA Stat Poll from November 9, 2021
Gastroenterology Consultantas of South Texas (GCST)
Gastroenterology Consultants of South Texas (GCST) is a thriving practice in the Rio Grande area of Texas led by the strong leadership of Dr. Nolan Perez. The group was founded in 2007 with only one provider. The practice has grown to 14 providers in 2 locations. The leadership team is loyal and have worked their way to the top by learning all aspects of running a successful practice.
The group’s financial performance was at the top-tier for similar size practices with A/R Days at 29 (below industry standard). This was also an opportunity to provide more employment opportunities for their local community. GCST is committed to providing the best clinical services and patient experiences to their surrounding communities.
Dr. Perez is a very astute businessman trapped in a physician’s body. Although his practice is successful, he knew there was room for refinement and after meeting the Metis team, he agreed to a comprehensive assessment of his practice to find opportunities for improvement. Metis confirmed that GCST is a top-tier gastroenterology practice with low denials and increasing charges and payments even during a pandemic. However, the Metis assessment report was so thorough it included reviewing operational and clinical opportunities. Dr. Perez saw the opportunities and the group agreed to a 12-month engagement. Metis leverage the analytical wizardry of Revelliance Solutions, to create a detailed Business Treatment Plan.
The Metis Touch
The GCST engagement started in the middle of a global pandemic, which meant the remote touchpoints provided by Metis were critical. The key to any revenue cycle project is a consistent communication plan, so we established our weekly “Metis Touch” virtual meetings.
The meetings allowed for practice management and Metis consultants to review performance reporting weekly but more importantly discussing any trends and constantly gauge the engagement overall performance and remain step-in-step with each other. We have found, projects that do not meet client expectations are a direct response to the lack of communication, which leads to unrealistic expectations. Metis developed a scope expectation document during the first month with GCST to clearly articulate what the engagement team was responsible for versus the GCST staff. The practice had never worked with consultants so to avoid the “magic wand” approach with assuming the consultant would provide all the answers.
Success of the Partnership
The project was a successful collaboration with outstanding results:
- Increased Cash Collections by 24%
- Reduction of A/R Days by 4 Days
- Decreased A/R > 90 Days by 5%
Findings and Areas of Opportunity
The project was a successful collaboration with outstanding results:
Automation and Training
- Engaged a Patient Statement Vendor to reduce the manual task of sending patient statements.
- Increased communications with payors to provide more electronic payment postings eliminating the need for staff to post payments and providing more settlement payments for payor backlog issues related to COVID.
- Implemented an Issues Log to track training opportunities for front-end staff related to missing and inaccurate demographic and financial information.
- Implemented automated scripting to adjust aged and smaller balances without human intervention.
Process
- Implemented Financial Clearance Process to hold staff accountable for meeting payor requirements and collecting outstanding patient balances prior to the scheduled appointment.
- Created a Self-Pay Solution by implementing text functionality, online payment options and standardizing Payment Plan policies.
- Assisted with vetting and engaging a reputable Collection Agency to increase Bad Debt Recovery.
- Developed Credit/Refund Policy & Procedure to ensure refunds and posting errors are resolved timely.
Analytical Reporting
- Increased analytical reporting such as Payor Report Cards, E&M Distribution by Provider, New Patient to Procedure Conversion %, Controllable Denial CAS Code Reporting, etc.
- Redesigned Collector’s Work Queues to increase collections and avoid missing appeal deadlines.
- Tablespace Optimization – worked with the Practice Management System to fully utilized all modules and reporting to increase collections and efficiencies.
The partnership between GCST and Metis proved that even a successful practice can be made better and more efficient with the help and insight of the Metis Difference.