Tribal Healthcare Facilities
Third-party resource opportunities were not established at the initial start of the client’s contract with Pergroup.
Pergroup assisted client with enrollment with third-party payers, allowing the client to begin billing for medical services they were providing.
An accounts receivable process had not been developed to track the client’s third-party payer collections as they did not have a RPMS accounts receivable package.
Pergroup developed an accounts receivable collection tracking tool outside of RPMS that allowed the client to track every claim to a final disposition and confidently track their third-party collections. Pergroup provided a monthly management report of not only revenue generated and collected, but also of provider case load reports and clinic visit count reports. Collections went from 0 to surpassing $300,000 in each of the last three fiscal years.
Client had significant, persistent medical coding backlog causing continued non-compliance with Internal Control Policies.
At the initiation of the contract period with Pergroup, client’s facility had a continuous coding backlog in excess of 30,000. Pergroup assisted in implementing a six-month timeline for erasing the backlog and was successful in completing the task two months ahead of schedule.
A new Pergroup client was experiencing a significant third-party billing backlog for private insurance claims, as well as specific quality assurance issues such as incorrect coding of immunizations, incorrect use of modifiers and missing ordering provider information among other items.
With assistance from Pergroup’s highly trained and experienced staff, client was able to get back on track, erase its third-party billing backlog, avoid significant losses in revenue, review its procedures, implement quality control measures, and surpass its revenue collection goals, something the client had not been able to achieve on their own or using other contractors.