Case Studies

A Comprehensive Solution to Overcome Challenges in ACR & Medical Billing Process


The urgent care clinic of an integrated healthcare facility located at Maryland, USA.

The challenge faced by our Customer

The client was managing 700+ claims per month, and faced stiff billing challenges for the following reasons:

  • Errors due to incorrect patient / healthcare provider / and insurance provider information
  • Errors due to incorrect/mismatched/absent medical codes

On top of these the client often had to contend with issues like poor documentation, and duplicate billing. The cumulative effect of these shortcomings was a steep decline in collections. So, the client approached us to overhaul and improve their billing systems.

The Solution

Having built many solutions for hospital and clinic billing needs, we believed there was an urgent need to have a dedicated team for the project. So, we handpicked experienced coders, billers and AR specialists from our pool of resources to handle the client’s account. The team redesigned the existing billing and AR processes which made it easy to spot coding and documentation errors. Additionally, we introduced the AdvancedMD software to manage the claim process in one place. This made it possible to:

  • Review, edit and approve charges online
  • Identify claim issues before submission
  • Track follow-up history
  • Track denials
  • Build custom worklists of balance due-accounts
  • Generate payment plan statements
  • Send soft collection letters
  • Manage collection letters etc.

With the help of these measures we brought about a complete shift in the billing and collection process.

The Benefits

The significant shift in the billing process yielded rich dividends, as the client was able to:

  • Reduce average AR days from 34 to 23 within 6 months
  • Increase collections from 53% to 61% within the same period
  • Bring down errors to almost zero-levels
  • Reduce administrative work by half
  • Reduce dependency on staff
  • Keep stakeholders abreast of the developments

Leverage OutsourceRCM to Optimize your Billing System

OutsourceRCM's stands as a premier business process outsourcing firm, boasting skilled professionals located within 5 global delivery centers worldwide. Our comprehensive array of services spans inbound support to outbound call center solutions, providing a holistic resource encompassing human expertise, process acumen, advanced technology, infrastructure support, and rigorous quality assurance measures – all geared toward amplifying the scalability of your business operations.

If you seek a dependable, lucrative, and synergistic healthcare BPO partner to realize your goals, we encourage you to establish prompt contact with us