RCM Improvements for a Growth-Minded Organization
Case Study: North Country Home Health & Hospice Agency
The impact of strategically tackling AR
Overview
North Country Home Health and Hospice Agency (NCHHHA) is dedicated to caring for patients and families as they navigate their healthcare journey at home. They offer a wide range of services including home health care, palliative care and hospice care. NCHHHA has a broad reaching impact on the New Hampshire community and currently serves 51 communities in Coös and Grafton counties.
The Objective
NCHHHA wanted to focus on improving some key financial metrics such as cash collection and accounts receivable (AR). They faced challenges with multiple-payer setup issues, which resulted in aging AR. This was a significant challenge, given the prevalence of the multiple-payer financing model in home health. Additionally, there were struggles with claims – both in the context of aged claims and issues with payers not swiftly moving forward to the next steps for payment. This presented an opportune moment to dive into revenue cycle improvements. When NCHHHA engaged with Netsmart RCM services, they were in a growth and improvement mindset following their transition from a different EHR provider to a Netsmart care record.
The Solution
NCHHHA enlisted the Netsmart RCM team to address the root causes contributing to cash collection and AR issues. The Netsmart RCM services team put financial expertise into action through a scope that included billing, AR follow up and cash posting services. Additional hours were put in to manage multiple-payer projects. Payer project management was an important element of these efforts. To expedite claim payments, Netsmart worked with provider representatives on processing issues and requested timely waivers, which addressed a number of payer set up issues. As a result, the agency successfully collected funds on outstanding AR that had previously been challenging to collect.
Outsourcing our billing and RCM and partnering with Netsmart has been one of the best decisions we have made for our agency. Aged claims were our biggest hurdle to tackle when we started our contract with Netsmart. The Netsmart team is a direct extension of our agency and feels the urgency we have to collect each dollar we bill for, and I could not be more thankful for them.
Tiffany Haynes, President and CEO
$130K+
increase in avg cash
41%
reduction in AR over 121 days
Avg 14 day
reduction of days in AR
99%
clean claim rate
Comparing cash collections between October 2021 - October 2022 to cash collections between November 2022 - November 2023
Comparing AR over 121 Days in November 2022 to AR over 121 Days in November 2023
Comparing AR Days from December 2021 - September 2022 to AR Days from January - October 2023
Clean claim percentage calculated via the average of July 2023 – December 2023 clean claim percentage data
