The rapid rise of fee-for-value models has produced new drivers for revenue cycle success, putting increased pressure on specialty practices to balance cost and quality outcomes across entire episodes of care, while continuing to maintain best-in-class fee-for-service revenue cycles. As the clinical and financial implications of MIPS began to emerge for one large urology practice with locations across Southeastern Michigan, they reached out to Integra Connect to first identify and then address the root causes of their slower-than-expected cash flows and unpaid claims.
After a comprehensive operational assessment, Integra Connect identified the most impactful improvement areas for the practice, including a lack of Account Receivables (A/R) tracking and no mechanism for documenting denials, which made staying on top of late or unpaid accounts a challenged and negated their ability to address these negative performance outliers proactively. To mitigate these operational gaps, Integra Connect:
- Redesigned workflows to drive more efficiencies and free up practice staff;
- Implemented A/R Business Intelligence to track aging claims, identify recurring reasons, and address them systematically; and
- Introduced a new system to track and analyze denials, enabling the practice to identify areas of opportunity, improve FCR (first pass ratios) and accelerate cash flows.
By transitioning RCM operations to Integra Connect, the practice accelerated its cash flows, optimized billing workflows and increased control over both fee-for-service and value-based care performance. After the first 6 months, the practice had already reduced aging claims (A/R >90 days) by 61 percent, significantly accelerating cash flows. Furthermore, it experienced a 77 percent reduction in rejections, resulting in a powerful financial boost to the practice.