Case Study
Assessment Reveals Opportunities To Accelerate Cash, Increase Productivity
- Customer: Pennsylvania health system
- Challenge: Conduct an in-depth assessment to identify technical and operational improvements that will create a self-sustaining, peak-performing revenue cycle
Results
Tegria’s assessment identified:
- $29 million in annual net revenue opportunity
- $17 million in cash acceleration opportunity
- $5 million in denial improvement opportunity
- $1 million in cost reduction opportunity
- 14 FTE bandwidth increase with recommended changes
Background and Challenge
Tegria partnered with a healthcare system in Pennsylvania to perform an in-depth Revenue Cycle assessment. The assessment focused on the hospital system’s contact center, front-end operations, and patient financial services. This highly-ranked over 500-bed hospital system sought technical and operational improvements that would create and maintain a self-sustaining, peak-performing revenue cycle. In collaboration with their leadership, Tegria identified opportunities to increase revenue, ensure patient retention, invest strategically, and improve the overall patient experience.
Solution
Tegria deployed a cross-functional team of experts to assess the organization’s revenue cycle, from a technological and operational perspective. The technical investigation identified opportunities to enhance automation, improve reporting capabilities, and modernize system functionality. The operational investigation identified long-term solutions, which included aligning best practice staffing, implementing and enforcing accountability, and establishing a streamlined governance structure.
Highlights of Tegria’s recommendations include:
- Contact Center:
- Establish governance structure
- Optimize phone system and related reporting
- Registration & Eligibility:
- Consolidate and automate payer and plan records
- Implement full EHR functionality
- Financial Services:
- Improve follow-up and denials management processes
- Accelerate CFB and PB claim edits
- Implement automation to decrease credit liability
Results
Tegria’s comprehensive assessment identified and documented more than 40 themes and findings and presented 98 detailed recommendations with estimated benefits. Highlights include:
- $29 million in annual net revenue opportunity
- $17 million in cash acceleration opportunity
- $5 million in denial improvement opportunity
- $1 million in cost reduction opportunity
- 14 FTE bandwidth increase with recommended changes