Wilmington Medical leverages Brightree Professional Services to re-align billing process and improve denials and DSO

Wilmington Medical Leverages Brightree Professional Services to Re-align Billing Process and Improve Denials and DSO

Throughout 2016, Wilmington Medical Supply was having trouble managing its accounts receivables. Its days sales outstanding  (DSO) nearly doubled, and the denial rate was roughly double of what it should be for the company. It was hard to pinpoint an exact cause. According to CFO/COO John Holtz, it was probably a combination of factors, including the need for more staffing and focusing mostly on current patient account activity rather than the outstanding A/R. Following the company’s conversion from another billing system to Brightree, its billing team was learning a new software system but had expected to receive even greater results.

Wilmington Medical deals with nearly all 50 states for Medicaid, Medicare, managed care and private insurance plans, so getting – and keeping – A/R results on track was an important part of the business and needed to be addressed.

Going Beyond Good Customer Service

In March 2017, Wilmington Medical arranged for a consulting services engagement with Brightree Professional Services to see what improvements were possible. The goal of the initial consultation was to support Wilmington Medical’s billing team with Brightree best practices for A/R, identify areas where the staff could use additional training, and find underlying causes of excessive denials and high DSO. Brightree Senior Consultant Melissa Wagner spent time with the billing team, learning about their workflow process and going through the numbers. She talked with the staff to determine what was causing delays in the collections process and how to correct the problem.

During the following weeks, Melissa continued to work with the staff and provide subsequent recommendations, which led to restructuring the A/R team to separate the cash application function from billing and collections. She worked to implement and utilize the Brightree Revenue Cycle Worklist (RCW) functionality to address denials more effectively. Several other configuration opportunities and reports were also identified as a means to optimize the use and function of Brightree. The idea was how to best increase efficiency and accuracy of their billing process with Brightree’s management capabilities.

“We’re becoming much more effective and efficient as a result of using revenue cycle worklists within Brightree. We’re measuring our denials and DSOs on a weekly basis and seeing improvement each week.”

Each time, Melissa re-engaged the team on the review process to make sure they were not falling short of their goals. That personal touch is something Wilmington Medical strides itself on – the company’s motto is “Patients First and Foremost…Always!” – and the company recognized Melissa’s efforts. “Brightree consultants understand what we’re trying to accomplish, looking through either the reports or spending time with people,” John said.

Results that Matter

During the consultation, Brightree helped identify approximately $150,000 in Medicare charges from January 2017 that had not been submitted electronically. The claims were resubmitted and paid in early April. Also, after months of increasing DSO, there was a companywide decrease. The Wilmington branch, where Melissa spent much of her time, saw its DSO go from around 100 to 84. The reduction was achieved through the combination of Brightree consulting recommendations, analysis and support. The numbers, though, are only part of the story.

After reviewing the overall billing collections process, Melissa suggested to re-align how some of the staff was positioned to best utilize their workload. That included having two individuals dedicated to post the electronic remittance notifications (ERNs) as opposed to having several people do it and work the denials. The idea proved to be a great success; the ERNs are now posted in a more timely fashion. Plus, the transition helped free up their collection agents to focus on collecting the outstanding A/R and working through those denials and the revenue cycle worklist.

Seeing more revenue and an improvement in workflow has been great, but the real game changer, he said, was how Melissa worked with the staff to help them understand the functionality of RCW and how to correctly set up the worklists to drive daily activities of the billing staff.

“We’re becoming much more effective and efficient as a result of using RCW,” John said. “We’re measuring our denials and DSOs on a weekly basis and seeing improvement each week.”

The one-on-one instructions have also positioned Wilmington Medical for future success.

“It has been a tremendous success, and the team is looking at things from a whole different perspective that is helping facilitate our daily and weekly and monthly collection efforts,” John said. “I would fully anticipate that we will continue to see improvements because of the processes put into place and because the team now understands how to use the functionality of Brightree.”

“Brightree has been a sort of a lifesaver to our billing function and to our billing team, [showing us] not only how Brightree works but how to make Brightree work best for us.”

A Team Effort

While Wilmington Medical has been in business for more than 35 years, experience has taught John and his staff that there are still new tactics and tips that can improve operations. One thing that has not changed is the importance of establishing and building relationships. Wilmington embraced recommended process changes that resulted in positive outcomes. John has been complimentary of the patience and personal help from Brightree Professional Services.

“Brightree has been a sort of a lifesaver to our billing function and to our billing team,” John said. “Melissa came in with a philosophy and a view of not only how Brightree works but how to make Brightree work best for us… how to set up systems and processes within our daily functions and allow us to better attack our daily tasks. Part of her involvement has been a result of a health situation with my billing manager, where she actually stepped in and took over some of the tasks that he otherwise would have done.”

While John and his team praise Brightree for helping them get on track, Melissa attributes the success to their own efforts and dedication.

“I can lead them, but the Wilmington team deserves much of the credit to have actually implemented the recommendations,” she said. “That is truly where I gain the most satisfaction, to know that the work made a difference.”

 


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