DT Nephrology practice partnered with MedCare MSO in 2023 after facing serious billing challenges. Delays in claim follow-ups, coding errors, and a lack of reconciliation were hurting both revenue and operational efficiency. We fixed their billing processes, streamlined claim follow-ups, and improved coding accuracy. The results? DT Nephrology saw a huge increase in monthly collections, improved claim accuracy, and smoother operations overall.
Denial Rate
Monthly Collections
When MedCare MSO took over the DT nephrology practice in 2023, several critical issues were identified in the billing process
The DT nephrology practice was facing slow follow-up on claims, especially those from services provided at hospitals and dialysis centers. This led to a high number of delayed or lost revenue.
Errors in coding, whether due to incorrect modifiers or improper CPT codes, were leading to frequent claim denials and underpayments.
Without a formal reconciliation process in place, the DT nephrology practice team struggled to ensure that all patient visits were billed accurately, resulting in missed charges.
These challenges not only impacted DT nephrology practice financially but also hindered the overall operational efficiency of the office.
To tackle these challenges, MedCare MSO implemented a comprehensive set of solutions that targeted the key problem areas
MedCare MSO conducted a thorough audit of all past claims to identify discrepancies. Based on these findings, MedCare MSO provided tailored training sessions for DT nephrology practice office staff on proper modifier and CPT code usage.
A comprehensive SOP was developed to streamline the entire billing process. The SOP included pre-checking all claims for accuracy, verifying insurance eligibility, and reconciling patient visits with billed services.
A new systematic reconciliation process was introduced to ensure all patient encounters were properly billed. This helped prevent missed charges and ensured that all services were captured accurately.
MedCare MSO provided continuous oversight and real-time resolution of any issues. Regular communication with DT nephrology practice allowed for quick adaptation to any challenges as they arose.
These solutions ensured that DT nephrology practice was not only more efficient but also much more accurate in handling its billing and claims processes.
With MedCare’s MSO strategic intervention, DT nephrology practice experienced significant improvements in both revenue and operational efficiency.
| Metric | After MedCare MSO Services |
|---|---|
| Monthly Collections | $28000 |
| Days in A/R | 30 - 40 days |
| Denial Rate | 2% - 5% |
| Payment Tracking | 95% ERAs |
By outsourcing your billing services to us, you can expect revenue growth of up to 20%
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