Challenge:
Gravity Diagnostics, a laboratory that operates nationwide, was struggling with high denial rates for their services. This was putting their finances at risk, especially because they offer many different types of tests. The complex rules around getting paid for these tests made it hard for them to collect all the money they were owed. They needed a way to better manage their revenue and reduce the number of denied claims.
Approach:
To solve these problems, Gravity Diagnostics teamed up with us and used our RevenueIQ system. We focused on finding and fixing the main issues in their revenue cycle:
Identifying Problems:
We ran a thorough check of their revenue process to spot where they were losing money or facing inefficiencies. We combined data from different sources to give them a clear picture of where things were going wrong.
Applying Solutions:
Real-time Monitoring: Our system allowed them to track important performance indicators in real time, which helped them catch and fix problems quickly. This reduced denial rates and improved payment outcomes.
Underpayment Alerts: The system also flagged payments that were less than expected, allowing the team to recover lost revenue.
Revenue Forecasting: By predicting future payments based on current data, the lab could make better financial decisions and reduce risks.
Monitoring Payer Behavior: By understanding how different payers were responding, the lab could adjust their billing practices to get more claims approved and paid.
Continuous Improvement:
We continue to monitor and fine-tune their revenue cycle to make sure they keep seeing improvements in their financial performance.
Impact:
The results were significant:
Fewer Denials: They saw a 24% drop in denied claims, which helped secure their financial health.
More Resolved Denials: They were able to resolve 370% more denials, which improved their cash flow.
Higher Payments: The average payment rate increased by 27%, boosting their overall revenue.
