Hexaware Masters Accounts Receivable Follow-up Challenges and Elevates Revenue Cycles for a Leading Hospital Billing Company 

Client

Our client is an analytics-driven company and a world-class service provider. It provides revenue cycle services, processing millions of transactions every day for 86+ hospitals across 15 states in the United States.  

Challenge

For a major player in the field of hospital billing, optimizing Accounts Receivable (AR) follow-up and collections is imperative to ensure financial stability.

Our client faced several critical challenges in AR that necessitated a strategic transformation:

• Low Balance AR Follow-up for Hospitals: The client grappled with effectively managing low balance AR follow-up for hospitals, leading to a growing backlog.
• Complex AR Follow-up for Physician Services: With little experience in physician billing services, the client had to navigate complex AR follow-up for physician services.
• High Volume of Account Closures and Clerical Requests: A substantial workload was attributed to account closures and clerical requests, adding to the operational strain.

What the client wanted:

• Handle AR Follow-up for Providers: Given the client’s limited experience in physician billing, the primary focus was on AR follow-up for providers.
• Resolve Backlog: The aim was to resolve the backlog of AR follow-up effectively and efficiently.
• Reduce AR Balances in >180+ Days Bucket: The client expected a substantial reduction in AR balances in the >180+ days bucket within a short three-month period.
• Go live faster: There was a pressing need for rapid implementation setup and a quicker go-live ramp-up of AR operations.

Solution

To address these challenges, Hexaware used technologies, such as a fully automated AR management tool, issue log tracker, and document repository to devise a multifaceted solution:

• AR Segmentation: AR was segregated into aged and new categories, allowing for the mapping of reimbursement timelines and the identification of trends with various carriers.
• Specialized Knowledge Pool: A specialized knowledge pool was created to focus on AR follow-up for claims older than 90 days.
• Analysis: An in-depth analysis of customer and denial reasons was conducted to enhance efficiency.
• Implementation Plan: A comprehensive implementation plan, spanning one week of planning and technical setup, along with two weeks of knowledge transfer and training, was designed.
• Pilot Run: A one-week pilot run was executed with rigorous output analysis and feedback incorporation, leading to a successful go-live.

Benefits

The implementation of this strategic approach led to substantial benefits for the client:

• DSO Reduced by 50% in 4 months
• Financial stability improved by 50%
• Collections on AR balances older than 180 days consistently increased by 6% monthly
• Productivity increased by 175%
• Identifying trends and patterns reduced call volumes by 60%

The robust transition methodology ensured a seamless transition and go-live process, minimizing disruptions.

Summary

A major hospital billing firm, grappling with low AR follow-up, sought transformation. Through AR segmentation, specialized knowledge pools, and innovative technology, DSO was slashed by 50% in under four months, with monthly collections surging by 6%. Enhanced productivity and efficient trend identification further boosted the revenue cycle, highlighting the power of strategic planning and technology in healthcare financial management.