Case Studies

Revitalizing Medical Billing Processes: Transforming a Florida-Based Medical Group's Operation


Founded in 2009, our client is a prominent Florida-based medical practice comprising over 20 skilled practitioners dedicated to offering a diverse range of medical aid services.

Our client aimed to partner with us for streamlined medical billing, focusing on reducing AR days, ensuring consistent charge flow, resolving claims issues, and addressing enrollment challenges.

We offered comprehensive solutions, including identification of underpayment and non-payment causes, streamlined medical billing workflow, implementation of structured reporting, seamless workflow processes, and effective communication strategies via calls and emails for improved outcomes.

The Story of our Customer

Our client operates as a distinguished medical practice, boasting a team of more than 20 skilled medical practitioners. Headquartered in Florida, they function as a prominent medical group, offering diverse medical aid services.

Their services encompass a wide range of healthcare offerings, including but not limited to diagnostics, treatment plans, surgical procedures, consultations, medication management, and preventive care measures. With their expert team and comprehensive approach, they cater to the varying medical needs of their patients, striving to ensure optimal health outcomes and patient well-being.

The challenge faced by our Customer

We utilized our expertise to identify key challenges, which encompassed:

  • Inconsistent charge flow leads to claims accumulation.
  • Contract policy violations due to improper claims processing.
  • Need for follow-up on claims.
  • Enrollment-related problems cause increased claim denials.
  • Delays from coding errors during claims processing.
  • System issues resulting in underpayment or non-payment of claims.
  • Claims denial due to authorization issues.

The Result

  • Streamlined workflows and targeted goals for comprehensive medical billing.
  • Implementation of a well-structured reporting system.
  • Efficient communication via calls and emails.
  • Enrolled non-par physicians with both non-government and government carriers.
  • Resolved issues affecting physician revenues.
  • Reduced outstanding AR to under 10% and halved AR days.
  • Addressed authorization-related problems.
  • Enhanced follow-up methods and appeals processes.
  • Offering lasting solutions and escalating issues appropriately.

Leverage OutsourceRCM to Serve the Customers Better

OutsourceRCM is a premier business process outsourcing firm boasting skilled professionals within five 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 insight, 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 contact us promptly.