Case Study: Implementing Medical Billing and RCM Strategies for a Leading Podiatry Clinic in Los Angeles, California
A case study on how Bristol Healthcare Services, Inc. transformed revenue cycle efficiency and improved financial outcomes for a leading Podiatry Clinic in Los Angeles, CA.
About Our Client
Our client’s Podiatry Clinic is a thriving practice located in the heart of Los Angeles, California. With a team of podiatrists, they specialize in treating a wide range of foot and ankle conditions, from sports injuries to diabetic foot care. Despite their expertise and strong patient base, the Clinic faced significant challenges in optimizing its revenue cycle management processes.
The Obstacles
The Podiatry Clinic struggled with inefficient billing processes, resulting in delayed reimbursements and increased denials. Their in-house billing team, while skilled, found it challenging to keep up with the complex coding requirements and payer regulations. As a result, the clinic experienced a high rate of claim rejections and an escalating number of pending accounts receivables. They recognized the need for a partner who could streamline their revenue cycle management and improve their financial performance.
The Journey
After researching various revenue cycle management providers, the client chose to partner with Bristol Healthcare, a leading healthcare consulting firm specializing in revenue cycle optimization for independent podiatry practices. Upon initial consultation, our data specialists conducted a thorough assessment of the clinic's current processes and identified key areas for improvement. And to assure the client of our longstanding expertise, we provided them with an open line to our esteemed clientele.
Our 6-Step Strategy
1. Comprehensive Revenue Cycle Analysis
Our team of analysts performed an in-depth review of the Clinic's revenue cycle, identifying bottlenecks and inefficiencies in their billing and coding practices. Through this analysis, we uncovered missed revenue opportunities and developed tailored solutions to address them.
2. Customized Coding Education
Recognizing the importance of accurate coding for maximizing reimbursements, our team of AAPC™ and AHIMA™ certified coders provided customized coding education sessions for the clinic's billing team. These sessions focused on proper documentation practices, coding guidelines, and strategies for reducing claim denials. Our coders also took over the coding audit process in the interim to ensure maximum accuracy.
3. Implementation of BristolByte™
We implemented our proprietary, advanced workflow management software to automate billing processes and provide real-time insights into the clinic's financial performance. It helped track and monitor the entire administrative process including all sub-processes (coding, demo, charges, payments, and AR), workflows, and work assignments. With 24x7 cloud-based connectivity to the ERA interface, insurance eligibility information, and other significant data - BristolByte™ equipped the Clinic with the tools to leverage data to streamline and future-proof its operations.
4. Payer Contract Review and Negotiation
Our team of Accounts Receivable specialists conducted a thorough review of the clinic's payer contracts to ensure they were receiving optimal reimbursement rates. They also negotiated with payers to secure favorable contract terms and maximize revenue potential.
5. Denial Management and Appeals Process Improvement
We developed a tailored, robust denial management strategy to identify low-pays, no-pays, and current denial trends and patterns to identify root causes. Through improved documentation and appeals processes, our AR Specialists worked to overturn denied claims and accelerate reimbursement timelines.
6. Ongoing Performance Monitoring and Support
After implementation, Bristol Healthcare continues to monitor the clinic's revenue cycle performance and provide ongoing support to address any emerging issues or irregularities. Through periodic performance reviews and data analysis, we ensure that the Clinic maintains optimal financial health.
The Results
In just seven months of partnering with Bristol Healthcare, the Podiatry Clinic achieved significant improvements to its revenue cycle:
- Claim rejection rates decreased by 22% leading to faster reimbursements and improved cash flow.
- Aged accounts receivable reduced by 26%, resulting in better financial stability for the Clinic.
- Coding accuracy improved to 98%, minimizing compliance risks and maximizing revenue potential.
- Overall net revenue increased by 12%, allowing the Clinic to invest in further growth and expansion opportunities.
Through the strategic partnership with Bristol Healthcare, the Clinic successfully transformed its revenue cycle management processes, positioning itself for long-term success and continued growth in the competitive healthcare landscape.
“I cannot speak highly enough of the incredible work done by Jay and his team in transforming our revenue cycle management processes. Before partnering with Bristol, our clinic was facing significant challenges with billing inefficiencies and claim denials, which were impacting our financial health and ability to provide quality care to our patients.
From the moment we engaged with Bristol, their team demonstrated unparalleled expertise and dedication to understanding our unique needs. They conducted a thorough assessment of our revenue cycle and implemented personalized solutions that addressed our specific pain points. Their guidance in optimizing our coding practices, negotiating favorable payer contracts, and implementing advanced software solutions revolutionized our billing operations.
Thanks to Bristol’s strategic approach and ongoing support, we have experienced remarkable improvements in our financial performance. Claim rejection rates have plummeted, pending accounts receivable significantly reduced, and our overall net revenue has seen a substantial increase. Their commitment to excellence and diligence has truly had influence on the success of our Clinic.
I wholeheartedly recommend Bristol Healthcare to any organization seeking to optimize its revenue cycle and achieve lasting financial stability. Their expertise, professionalism, and personalized approach have been instrumental to our clinic's growth and success.” - CEO and Founder, Podiatry Group Practice
Certified Podiatry Expertise: Future-Proof Your Finances
Podiatry is more than just a specialty for us; it's our expertise. Our team comprises certified professionals who are well-versed in the intricate world of podiatry billing, coding, and accounts receivable management. We're not just here for today, we’re here to future-proof your billing processes and adapt seamlessly to industry changes.
Learn more about our podiatry billing services.
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