RESULTS
Increased Collections
$ 0 k/year
Task Reassignment
0 FTEs
Staff Satisfaction
0 %
Automation allows staff to focus on denials, recouping $900,000/year
SphereGen Case Study
Managing claim denials is a costly business for Providers. Some lose almost 5% of their net patient revenue annually on denied claims.
Due to staff shortages our client, a rural hospital, was not able to keep up with pursuing denials for payment, resulting in even higher percentages of denials cost.
By implementing Intelligent Automation and working with us to automate several of their RCM processes, our client saved over 200 hours/week. With so many hours freed up, staff could now focus on pursuing denials – complex tasks which require person to person engagement.
As a result, our customer recovered over $900,000 in denied claims.
Automation allows staff to focus on denials, recouping $900,000/year
SphereGen Case Study
Managing claim denials is a costly business for Providers. Some lose almost 5% of their net patient revenue annually on denied claims.
Due to staff shortages our client, a rural hospital, was not able to keep up with pursuing denials for payment, resulting in even higher percentages of denials cost.
By implementing Intelligent Automation and working with us to automate several of their RCM processes, our client saved over 200 hours/week. With so many hours freed up, staff could now focus on pursuing denials – complex tasks which require person to person engagement.
As a result, our customer recovered over $900,000 in denied claims.
O V E R V I E W
Managing claim denials is a highly manual process requiring the work of multiple staff members. Many providers cannot afford to dedicate the needed staff to handle the burden of denied claims.
Our client, a rural community hospital, automated multiple RCM processes. This allowed staff to refocus efforts on pursuing denials, recovering $900,000 in claims which would have been written off.
Challenge
Being a rural hospital, hiring and maintaining staff was posing continual issues. When staff numbers were low, work burdens were overwhelming – affecting staff morale and productivity. Training new staff required months of dedicated resources. There simply weren’t enough people to process the amount of claim denials. The end result meant higher overall costs for the hospital.
SOLUTION
Partnering with the hospital, SphereGen implemented Intelligent Automation and automated several RCM processes such as eligibility verification, remittance posting and claims scrubbing. These automations saved over 200 hours/week for the RCM staff. Freed from many daily operational tasks, the RCM team could now focus on pursuing claim denials.
Staff was able to reclaim over $900,000 in denials, directly affecting the bottom line.
The RCM team achieved better workload balance, concentrating on intellectually challenging tasks which provide great savings to the organization.
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SIZED BUSINESSES
As a privately-held small business, we understand the goals, needs, and challenges of organizations your size. SphereGen leverages 10+ years of experience to find the ‘best technology fit’ for clients whether you build, buy or customize software and services.