Improved Execution of Critical Billing and Regulatory Procedures

In the healthcare industry, billing is one of the most significant hurdles for providers and patients with 30% of claims either denied, lost, or ignored.1 Medical claim rejection and denials have a negative effect not only on revenue and billing department efficiency, but on trust between a health care provider and their patients.

As a result, healthcare organizations must spend increasingly more time on activities unrelated to providing care.  For smaller organizations and private practices, meeting regulatory obligations and managing insurance claims consumes an inordinate amount of time. If providers manage these details themselves, without One Best Way procedures, mistakes are made that put revenue at risk and take even more time away from patients.

Outcomes

  • Enabling clinicians to focus solely on patients
  • Increased capacity to take on additional patients
  • Improved billing experience for patients
  • Supporting company expansion from two to seven offices in two years

“Acadia is such a victory for us, because every hour we save our clinicians becomes an additional therapy session. That’s more people in our community who are getting to see a top-notch, highly-qualified clinician for an hour of therapy.”

COO

New Capabilities

  • Efficient billing procedures and policies
  • Streamlining how billing information is collected
  • Repeatable processes for standing up new offices

More than 20 million people nationwide live with a substance-use disorder. Yet only 10% receive treatment for the condition.2

Our client provides person-centered, intensive outpatient therapy to individuals seeking to achieve long-term recovery from mental health and substance use disorders. They do this by contracting with clinicians to provide care, while they provide offices and shared services to manage all back-office requirements.

Consistent, streamlined execution of critical billing and regulatory procedures enables clinicians to focus on their clients’ recovery.

Through One Best Way procedures in Acadia, clinicians know how to capture details from patients, and avoid billing process issues from the start.

In intensive outpatient therapy (IOT), time is the difference between being treated or not. Now, the time our client’s clinicians save translates directly to time they can spend with their clients.

The company is prospering and as demand for their services grows, they are expanding their footprint to additional offices. In the past two years, they’ve opened 5 additional offices, allowing them to help even more people. With each new office, there are state and local regulatory requirements, licensing conditions, and general office needs to be met. The operations leader has developed a procedure in Acadia to follow for each new office project – making sure all requirements are met and new office openings happen quickly and efficiently. 

Sources:

  1. Medical Claim Denials & Appeals: Statistics That You Want to Know
  2. 90% who need substance-use disorder treatment don’t get it

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