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SCALE MSO Operations – RCM News

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SCALE MSO Operations – RCM News

October 2022

Scale completed an assessment of a large dental services organization.  Scale identified underperformance in denial and AR management resulting in significant loss for the DSO.  Our RCM experts created a corrective action plan and Scale will likely lead the improvements as interim director.

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August 2022

SCALE RCM completed an assessment of a private equity backed orthopaedic practice.  SCALE found deficiencies in the denial and AR management process affecting cashflow and collections.  The average response time to a denial was nearly 18 days.  Additionally, SCALE identified rule engine overrides by the internal billing team that almost always resulted in denials.  SCALE provided clear examples to the client to review with their billing vendor and internal team and recommended additional monitoring and measuring of these processes as a KPI.  

 

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July 2022

SCALE RCM assessed three disparate billing solutions for a recently merged practice. We identified significant underperformance in both their internal and external physician billing teams and recommended immediate changes to reduce loss and maximize cash flow. We helped develop pathways for integrating to one RCM solution are now assisting in selecting and implementing the solution.

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June 2022

This month SCALE RCM onboarded a 16-provider nephrology practice in 1 week and immediately increased cash flow by over $50,000 by immediately addressing a backlog in claim creation and submission. SCALE RCM is working with the practice to streamline internal operations that impact RCM. Learn more about our full-service and consulting services.

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May 2022

SCALE RCM onboarded an endocrinology practice in 2 weeks and immediately increased cash flow by over $100,000 with proper responses to medical record requests. Additionally, SCALE RCM worked with the providers to eliminate coding issues to increase throughput.

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April 2022

SCALE RCM is now providing fully managed RCM services to a Primary Care Client and an ENT Client. Additionally, we are proud to share that the SCALE team has identified an additional estimated $86,000 in claims reprocessed on behalf of a Client and we closed their books timely for the third month in a row, which shows significant improvement.

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March 2022

SCALE RCM is working in partnership with a client’s internal RCM management to design a standardized diligence program for its accelerated acquisition plan. SCALE RCM will provide the external expertise to document the current RCM leadership and performance, assess risks, and identify opportunities for improvement post-close.

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February 2022

SCALE RCM is providing Interim RCM Leadership on behalf of a client as they seek to hire an RCM Manager and transition from an in-house billing team to an outsourced solution. We are also assisting with the talent search and selection process.

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January 2022

SCALE RCM assisted a practice in need of customized interactive reports for practice managers and member providers not present in the EHR/PM system reports or its integrated BI tool. We created a custom BI tool that provides timely insight to billing, coding, collections, and other financial data to the practice and its internal customers.

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December 2021

2021 SCALE RCM Client Highlights

1. Provided Interim VP, sourced a FTE, and deployed team to assist with payment posting process under 1 Tax ID on behalf of Client.
2. Immediate mobilization of our team for a 3-week project with 2 checkpoints on behalf of Client.
3. Long-term project to analyze MidLantic RCM, compare to Client’s business units using Unit Economic and performance data, and create roadmap for one MidLantic RCM team.

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November 2021

SCALE RCM’s client recently experienced employee turnover which led to two opportunities to temporarily assist. First, the client had an immediate need for trained coders. Within two weeks Scale RCM provided 2 FTEs with specialty-specific experience and immediately supplemented their existing staff. Second, new team leadership in payment posting allowed us the opportunity to train the new supervisor onsite as well as take the lead in implementing updated reconciliation procedures.

October 2021

SCALE RCM’s Private Equity Client needed immediate confirmation of the status of a multi-state practice’s transition from outsourced to in-house billing, projected cost savings, and  increased collections.  We mobilized immediately, presented an interim report within 2 weeks, and a final report the following week.  The Client gained valuable, actionable insight and we provided recommendations for performance improvement and scalability.

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September 2021

SCALE RCM created and maintained a Power BI model for a growing practice to create custom dashboards and make predictions based on contracted and provider credentialing status. SCALE RCM assisted the Client’s analytics team to take over administration of the tool.

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August 2021

On behalf of a sponsor Client, SCALE RCM performed a RCM Assessment and found significant unworked insurance AR resulting in delayed cashflow and permanent loss. We deployed a full-time experience AR resource within a week to augment the understaffed AR team.  As we work through the AR we are also assisting with fixing the root cause of denials as well as documentation and training.

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July 2021

On behalf of a sponsor client, SCALE RCM performed a unit economic analysis and quality assessment of six distinct RCM teams on the client’s platform. We developed a recommended integration pathway forward and modeled best practice billing performance and overall cost for each team.

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