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Case Study: Bayada Home Health Care
Despite being a leader in home health care, BAYADA struggled with an antiquated revenue cycle management system. While the company was experiencing tremendous growth, their RCM system lacked connections to payers, had outdated edits, and lacked reporting, analytics and a process for managing denied claims.
Using claims management, denial and appeal management, payer payments and eligibility verification tools from Waystar, Bayada was able to improve:
– 72% decrease in denial rate
– $2.5 million recovered in just six months with Denial & Appeal Management
– 51% drop in average days to payer receipt
– Improvement in clean claims rate to 97%
– 93% productivity improvement
Waystar helped Bayada enhance their RCM system to better serve their dynamic, growing organization. They improved reimbursements, reduced costs and increased staff productivity. “Working with Waystar was a night and day change for us,” said Will Boyd. “We have more confidence than ever that our processes work and our claims will be paid.”
Case Study: Novant Health
As in many health systems, charge capture leakage was an ongoing problem for Novant Health. Human error, new charges, and new team members not yet familiar with the workflow all contributed to missed charges and lost revenue. The charge capture tool Novant Health was using required extensive review to identify real missing charges and did nothing to prevent them from happening again.
Waystar Charge Integrity was attractive to Novant Health’s revenue integrity team first and foremost because, unlike before, they would be able to quantify the return on investment (ROI). They also liked the nimble reporting function, which would allow them to report for 14 clinical areas, quickly and easily. Novant Health recognized that Waystar could deliver additional value including a significant reduction in false positives by accounting for the health systems unique charging practices and by sharing industry knowledge and insight into new opportunities for improved revenue capture.
Within the first 15 months after implementing Waystar Charge Integrity, Novant Health identified $7.5 million in net revenue.
Case Study: Emergency Mobile Health Care
Emergency Mobile Health Care (EMHC) was founded to be and remains an exclusively locally owned and operated emergency medical service organization. Yet with growth and success came additional billing and back-office complexity, impacting not only operational efficiency but administrative demands on patients and patients’ families—EMHC needed a solution that streamlined billing for staff and patients alike, rather than continuing to outsource billing and continuing to watch billing costs rise with seemingly no end in sight.
EMHC selected Waystar’s Eligibility Verification, Claims Management and Patient Payments solutions to tackle these challenges. “Efficient billing is a major challenge for many EMS organizations,” explains Justin James, EMHC’s Chief Technology and Revenue Officer. “Responding to denials and collecting payment on transports for patients with incorrect or non-existent insurance is a persistent cost-driver and frustration for many in EMS billing.”
With Waystar, EMHC has seen improvements in the following areas:
– Increased collection rates by 30%
– Improved bottom line by moving billing in-house
– Now handle 2X the billing volume with >20% fewer dedicated FTEs
Case Study: Baptist Health
Baptist Health is the largest not-for-profit health system in Kentucky, with seven hospitals, over 250 out-patient facilities, and a comprehensive physician network. Its affiliate, Baptist Health Medical Group (BHMG), brings together over 800 of Baptist Health’s providers into one physician-led multi-specialty network. Separate financial services operations for Baptist Hospital and BHMG—and disparate patient management, EHR, and revenue cycle software used by affiliated practices and physician groups—were creating unnecessary complications and costs.
Baptist planned to replace its multiple healthcare information management systems with Epic.
But they first wanted to standardize on and implement a single clearinghouse and end-to-end revenue cycle management platform, both to make the transition to Epic smoother and less disruptive and to support the consolidation of Patient Financial Services into a single billing office.
“Waystar’s excellent solutions and exceptional client service as well as the proposed cost savings made it an easy choice,” says Donna Ghobadi, Vice President of Revenue Cycle and Managed Care. “Now we’re using Waystar’s solutions across our entire revenue cycle to maximize payments from patients and payers while boosting our efficiency.”
With Waystar’s technology solutions, Baptist has been able to:
– Save over $250K annually in recurring operating costs
– First-pass clean-claims rate improved by 13% to over 98.5%
– Provide greater transparency across the revenue cycle
– Increase patient collections
– Enhanced interoperability and a smoother transition to Epic
Case Study: Yuma Regional Medical Center
Like every major hospital, Yuma Regional Medical Center saw opportunities for improvement through-out the revenue cycle. A high priority was capturing missing charges. Other issues affecting the hospital’s bottom line were bad debt and write-offs from self-pay and charity patients.
To solve their charge capture problems, the hospital selected Waystar Charge Integrity, largely because it uses predictive analytics to uncover charges that rules-based products can’t find. To identify underlying causes so we solve problems on the front end, they also utilized Waystar Denial Avoidance, which identifies root causes of denied claims and prevents them from happening in the future. The solution uses a combination of intelligent workflow, reporting, analytics and advisory services to involve the entire revenue cycle in process improvement.
To reduce bad debt and write-offs, the hospital added Waystar Coverage Detection, which uses proprietary financial intelligence based on more than a decade of healthcare data to identify patients’ active and inactive insurance coverage when they don’t know if they have primary or secondary insurance.
Waystar’s solutions are helping Yuma Regional Medical Center improve processes and bottom-line contributions throughout the revenue cycle, including:
– $27 million net revenue identified
– $17 million total denial improvement and 5% improvement in denial collections in 22 months
– 4.6% increase in net revenue
– 20.4% average hit rate on insurance coverage for patients presenting as self-pay
– $2.7 million in additional collections for self-pay and payer variance
Case Study: Health System
This health system faced three common revenue leakage problems: missing charges, denial write-offs and productivity inefficiencies and purchased Charge Integrity, Professional Charge.
Integrity and Denial Avoidance solutions from Waystar helped the health system bring their charge integrity, denials and self-pay processes up to the best practice levels they maintain throughout their organization.
Waystar’s solutions enabled the health system to realize these results:
– $12.9 million realized in missing charges rebilled, write-off reductions, self-pay collections and other process improvements
– $2.5 million in net revenue identified
– Write-offs reduced 50% for
– $6 million in net revenue improvement in 14 months
– Net revenue increased 1.5% over five months
– Denied charges reduced 8%; denied dollars reduced $5 million in three months
– Self-pay collections increased $5 million in 14 months
Case Study: Cincinnati Children’s Hospital
If there’s one goal all healthcare providers have in common, it is to reduce costs. At Cincinnati Children’s Hospital Medical Center, lowering costs to provide better value to patients and families is a high priority. To achieve this goal, Cincinnati Children’s administrators sought a new revenue cycle solution in Waystar to cut costs and manage cash flow.
Before implementation, Waystar focused on three areas they considered critical to success:
– First, they scoped Cincinnati Children’s hospital, physician and homecare accounts receivable (AR) and met with the billing teams to understand and document existing process flows.
– Second, they captured billing edits for all three ARs to determine if they were valid and correct before they transferred them to the new system. They also improved first pass payer claims acceptance by quickly coding new edits as needed.
– Third, they managed payer enrollment quickly and thoroughly to avoid denials and cash flow issues.
By implementing Waystar’s claims clearinghouse solutions, Cincinnati Children’s cut their clearinghouse costs in half, saving $400,000 annually with no loss of functionality or efficacy. They maintained cash flow and strong AR metrics, both during and after implementation.