Optimizing Healthcare with eCW RCM Consulting

Results

  • Increased Efficiency: Streamlined workflows and enhanced operational efficiency
  • High Service Volume Management: Efficiently manage 32,000 services per month
  • Optimized Payment Posting: $7 million in monthly postings managed by just two staff members
  • Improved Accuracy:
    • 475 rules implemented for thorough claim scrubbing.
    • Accurate tax ID numbers, provider overrides, and CPT codes validation.
  • Enhanced Front-End Processes: Effective use of electronic posting and CASS configuration for better claim scrubbing
SandyWashburn-CompassHealth-RCM-CSS-headshot

“eClinicalWorks RCM consulting services have been so valuable to Compass Health, we have been able to streamline our workflows and make them much more efficient. Compass renders 32,000 services a month, approximately on an average. And with that, we have two people in our payment posting department who posts $7 million each month towards those services.”
– Sandy Washburn, Chief Operating Officer, Compass Health Systems

Problem

Compass Health Systems faced several challenges before engaging with eClinicalWorks RCM™ consulting services. After 10 years on eClinicalWorks, their system needed a thorough review to ensure optimal efficiency. They struggled with managing operations across nine outpatient offices and 80 nursing homes in 12 states. The complexity of handling 32,000 services per month with only two people in the payment posting department, who managed $7 million each month, added to their operational inefficiencies. They also needed to ensure accuracy in tax ID numbers, provider overrides, and CPT codes for various insurance companies and specialties, which required meticulous claim scrubbing.

Solution

By leveraging RCM features such as electronic posting and the Coding Accuracy Support System (CASS) configuration, Compass Health Systems improved their front-end claim scrubbing processes, which significantly streamlined the back-end payment posting. The implementation of 475 rules in their system ensured that claims were scrubbed accurately, validating tax ID numbers, provider overrides, and CPT codes for different states and insurance companies. This comprehensive setup enabled Compass Health Systems to handle their complex operations more efficiently and effectively.

About Practice:

Compass Health Systems is a leading healthcare provider with a robust presence in the industry. They operate nine outpatient brick-and-mortar offices and provide services to 80 nursing homes and assisted living facilities. With operations spanning across 12 states, Compass Health Systems is committed to patient well-being, supported by a dedicated team of 160 clinical staff members.
Website: www.compass-md.com