Operating in fourteen diagnostic imaging locations in Tennessee, a radiology network provides broad-scale patient access to over 50 board-certified, sub-specialized radiologists utilizing state-of-the-art diagnostic imaging technology, including PET/CT, MRI, CT, nuclear medicine, mammography, ultrasound, and X-rays.
A/R Aging Threatened Financial Stability Despite Rapid Growth
The need for collections outpaced the provider’s capacity as the network expanded to become the largest in Tennessee. The A/R team was overwhelmed by 120+ day past-due accounts; the accounting team was quickly facing nearly $10M in rapidly expiring A/R. Time was of the essence with filing and appeal deadlines rapidly approaching. If the network was going to recoup nearly $10 million in potential lost revenue – an outcome that could threaten the organization’s financial stability – it had to find an experienced, proven, and fast solution.
Infinx’s ARDM Was Chosen To Help Work Down A/R
The imaging network organized a search for an external RCM partner to meet two critical requirements: the vendor must have: 1) proven experience with A/R and 2) a viable solution backed by an ironclad SLA that included aggressive performance targets, audits, and reporting.
Top decision makers selected Infinx Healthcare for its proven track record in delivering high-quality aging A/R solutions to providers across the nation for more than a decade. They were excited to use our AI-powered A/R Recovery & Denials Management solution (ARDM) to help identify and prioritize claims for recovery.
ARDM Finds Root Cause and Drives Reimbursement
With nearly $10 million at risk, finding the source of the denials in the face of looming expirations was urgent. The Infinx team moved quickly to implement ARDM and evaluate the collectability of outstanding denials and accounts receivable and create a plan for resolution.
Active Insights From ARDM Interactive Dashboards Drive Action
Machine learning and artificial intelligence analyzed revenue cycle data for display in ARDM to give clear direction on which claims to prioritize for recovery.
Denial Analyzer
This module rapidly determined the key source of the client’s aging A/R. Denials were largely due to authorization and medical coding-related rejections.
Prediction Module
This module determined which accounts were collectible, which had little hope of recovery, and which ones needed immediate action for revenue recovery.
Effort Optimizer Prioritization
This module ranked recoverable and collectible claims to maximize the amount recovered and increase cash flow as fast as possible.
RPA Realization
Robotic process automation executes eligibility, claim status checks, and automated support appeals. Infinx’s specialists worked on exceptions and addressed medical necessity queries with relevant medical records to satisfy payer requirements.
Over $14M Collected with ARDM Within 6 Months & Improved KPIs
In addition to collecting more than $14 million from 120+ day aging A/R inventory in 6 months, the radiology network experienced a dramatic turnaround in key financial performance metrics as shown below.
REDUCED
INVENTORY
$2.6 Million
120+ A/R inventory reduced to
$ 2.6 million, 11% of the total
outstanding A/R
IMPROVED
AGING
140%
The GCR on claims aging
120+ days improved by 140%
IMPROVED
COLLECTIONS
95%
Collections from 120+ A/R improved by 95%
ACCOUNTS
MAINTAINED
98%
Accounts were maintained at quality levels of more than 98%
Are you struggling to collect aging A/R and losing revenue due to missed filing deadlines? See how a large radiology network was able to use our AI-powered ARDM solution to dramatically increase collections.
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