Increase Practice Revenue with the Right EHR and RCM Service
Finding the right outsourced billing partner to manage your revenue cycle management (RCM) process makes all the difference if you want to grow your pediatric practice.
Established in 1984, Metro Pediatrics has flourished and grown into a thriving, four-provider practice serving the Birmingham, Alabama, community. However, the success of the practice presented a unique challenge – how do you keep up with growth while maintaining everything that goes into running a pediatric practice? And how do you expand those services during staffing shortages? These questions prompted the team at Metro to search for a partner who shared their vision for growth but could also help alleviate some of the stress of an overworked billing team. Enter Office Practicum.
Growth Leads to Change
In 2015, Metro Pediatrics was experiencing explosive growth. Their current EHR did not provide the clinical or financial tools to match their needs, so they began looking for a new EHR solution. After initial research, they invested in Office Practicum and knew they had found a partner aligned with their values. As their Billing & Coding Specialist, Congetta Coleman, recounts: “The fact that OP specializes in pediatrics makes a big difference.”
Then there was the matter of billing. Although the team could no longer do everything themselves, Congetta was nervous about the idea of outsourcing their RCM. She was doing it all and worried that no one would care as much as she did about billing. But with more than 70% of the practice’s patients using Medicaid as their primary source of insurance, something needed to give. The complexity of the rules and regulations around Medicaid was getting harder and harder. After careful consideration, the team decided to “go all in” and outsourced most of their billing to OP RCM.
Learning and Growing Through a Strong Partnership
Fast forward several years. Congetta and the entire Metro Pediatrics team couldn’t be happier with their relationships with the OP RCM team members. “I wanted them to care like me, and they do!” Congetta says. “I wouldn’t change anything they’re doing.” The partnership has translated into two essential facets and the lifeblood of any pediatric practice – increased billing and coding knowledge and more time to focus on patient care.
The knowledge and education delivered by the OP RCM team have proven invaluable for the providers at Metro. As a commitment to helping them grow their business, Metro learned about a source of revenue they had been leaving on the table without realizing it. “Our OP RCM rep told us about surveys – how we lost money because we were not billing for them,” Congetta explains. That change alone led to a 14% increase in PPV in just one short month.
Knowledge sharing has consistently benefited the practice since they signed on. The OP RCM team regularly reviews accounts for any issues with specific codes or trends in rejections that may impact the practice. Congetta notes, “They really do a good job of keeping the providers informed and updated on code changes, as well as other things we could be doing better – it makes a big difference.”
RCM Outsourcing Leads to Better Patient Care + Increased Revenue
With Metro’s RCM needs fully met, it was time to focus on providing even better patient care and exploring other forms of revenue the practice could generate using the clinical tools in OP. The free time gained by outsourcing their RCM has led to some incredible improvements. They recently obtained their Patient-Centered Medical Home (PCMH) certification from the National Committee for Quality Assurance (NCQA), further improving their overall quality of care and patient engagement.
No longer worried about billing, the practice was able to focus more on patient care and look for new sources of revenue. As a result, Metro launched a new initiative using the OP Demographic and Analysis Report (DAR) to track kids who were overdue for well visits. In just one month, charges and visits increased 24% above average, and patients received much-needed care. “Partnering with OP has helped our productivity and efficiency in every facet of our practice, without a doubt,” says Congetta.
These improvements are reflected in their overall numbers as well. Metro Pediatrics has seen a steady 5% increase in its gross collections rate (GCR), and its average payment per visit (PPV) has also increased by 14%. Congetta explains how RCM’s benefits have impacted them: “On the clinical side, they inform Dr. Dawkins about coding trends, then he informs the other providers on how to appropriately code. The end result is that it then trickles down to everything else.”
With the practice’s financial health secure, Metro Pediatrics is confident that continued growth will no longer present the issues that they had in the past. “OP always has our best interests in mind,” Congetta says. “Anything they find to bring in more revenue, they let us know, and that means a lot! I can’t sing their praises enough.”