Veradigm Revenue Cycle Services Exceeds Expectations & Achieves Revenue Cycle Excellence for the Clinics of North Texas: A Real-World Success Story of a Veradigm Client

Although physician and nurse shortages have garnered considerable attention recently, the healthcare industry's ongoing staffing shortages extend beyond front-line medical workers. In a recent MGMA Stat poll, medical leaders reported difficulties filling numerous positions in revenue cycle management, ranging from coders, billers, and schedulers to the front office staff responsible for verifying patient information.

These staffing issues have created numerous revenue cycle challenges for healthcare practices, such as:

• Increased days in A/R
• Increased numbers of denials
• Decreased staff morale and productivity
• Missed opportunities to pursue other available revenue opportunities

The Clinics of North Texas, one of the largest independently owned group practices in the 10-county Texoma region, is intimately familiar with the challenges of in-house revenue cycle management. The Clinics' combined network handles 250,000 patient visits annually with over 3 dozen physicians in more than 15 medical specialties. Their 200 employees include 20 in-house employees engaged in billing and collections workflows.

However, the Clinics' leadership was concerned that they were leaving money on the table. Their heavy use of manual processes for revenue cycle management contributed to numerous inefficiencies. As a result, much of their focus was retroactive, dealing with denials and waiting on appeals; the constant need to collect on outstanding balances prevented them from performing effective revenue cycle management. The onset of the pandemic further aggravated the situation as staffing for revenue cycle management became even more of an issue.

The Clinics of North Texas needed a solution that would help them deal with varying payer standards and keep pace with complex, ever-changing reimbursement requirements. They needed a solution that would help them reduce the number of days in A/R and reduce the administrative burden on their team. Finally, they needed a solution that would provide advanced predictive analytics with access to real-time data, not just end-of-month reports.

Finding the right vendor was an equally high priority for the Clinics of North Texas. They required a vendor who would take time to analyze and understand their existing workflows and help optimize inefficiencies. The Clinics did not want a vendor who would require them to switch practice management or EHR systems without adequate reasons. Finally, they desired a vendor who adequately understood the unique demands and requirements of Texas payers.

This paper tells the story of how the Clinics of North Texas expanded their existing partnership with Veradigm to implement a new revenue cycle management strategy that enabled them to simplify their business operations and improve collections. In this paper, you will learn how this collaboration yielded a range of successful outcomes, including:

• A 20% revenue increase in the first year
• 67% reduction in days in A/R
• A reduction of A/R over 90 days from 56% to 16%
• A 1.64% increase in gross collection rate

Learn how the Clinics of North Texas's success with Veradigm Revenue Cycle Services significantly reduced their administrative burden-and how the sum of improvements led to receipt of the 2021 Better Performers Award from the Medical Group Management Association (MGMA) in the Operations category. Most importantly, learn how the Clinics of North Texas's success freed up time for what matters most: delivering better patient care!