• Home
• About
• News and Events
• Case Study: Practice Drives Cash Flow and Reduces Costs with Integrated Claims and Payments

Case Study: Practice Drives Cash Flow and Reduces Costs with Integrated Claims and Payments

Download this Case Study: click here

“By using InstaMed’s Claims solution, integrated with our EMR software, we’re receiving payer payments two to three times faster – reduced from 20-45 days to 7-21 days – which, in turn, has accelerated our patient payments. And with automated payment posting and reconciliation, our payment process is simple, efficient and accurate, saving us 40 hours of administrative work per week and significantly reducing our costs to collect.”

- Leanne DiDomenico, Administrative Director, Performance Pediatrics

BACKGROUND OF PERFORMANCE PEDIATRICS

Founded in 2006, Performance Pediatrics is a primary care pediatric practice located in Plymouth, Massachusetts.

DESCRIPTION OF BUSINESS PROBLEM

Prior to InstaMed Performance Pediatrics was using inefficient processes to submit claims and process payer and patient payments, making it difficult to keep administrative costs low while maintaining the necessary cash flow to thrive as a start-up practice.

To submit claims to payers, Performance Pediatrics manually created each claim individually, and then manually posted the claims for electronic submission. This process was error-prone, costly and slow, as the practice frequently needed to re-process and resubmit rejected claims. By the time the practice accurately submitted a claim and received payment from the payer, more than a month had elapsed since the patient visit, which significantly delayed cash flow.

Once the claims were finally submitted and accepted by the payer, and Performance Pediatrics received the payment, the practice had to manually match the payment to the remittance advice. When the practice finished processing the payer payment, it was then able to bill the patient responsibility amount. To process these patient payments, Performance Pediatrics staff manually entered the individual payment information into a costly bank terminal that tied up a phone line. Finally, practice staff would individually post each payment. These manual multi-step processes to collect, post and reconcile payments were very time-consuming and resulted in inaccuracies and high operational costs.

THE SOLUTION

InstaMed’s solutions enabled Performance Pediatrics to improve efficiency in its processes to submit claims and process payer and patient payments to increase cash flow and reduce operational costs. The practice decided to use InstaMed because of its streamlined integration into their EMR, Office Practicum, making day-to-day tasks simpler, quicker and more accurate.

With InstaMed’s Claims solution, the practice has eliminated its manual processes by simplifying claims submission into one automated process, allowing staff to submit claims directly from the Office Practicum EMR software. Using InstaMed, the practice is able to identify errors up front with pre-submission edits, which has reduced claim rejections by improving accuracy. Once claims are submitted, Performance Pediatrics is now able to detect and manage all rejections in real-time with automated tracking, reducing time and costs spent on resubmission. By eliminating manual claims processes and reducing errors, the practice now receives payer payments faster, which accelerates cash flow.

Once the claims processing is complete, InstaMed’s Remittance solution posts the electronic remittance advice (ERA) directly into Performance Pediatrics’ EMR while automatically reconciling it with the payer payment. With a more accurate, efficient payer payment process, the practice now can bill and collect from patients more quickly to accelerate payments. To further automate the patient payment process, Performance Pediatrics uses InstaMed’s Patient Payments solution, which enables Performance Pediatrics to efficiently collect patient payments while the patient is still in the office. Furthermore, this solution has allowed the practice to replace its costly bank terminal with a card swipe device, eliminating the cumbersome task of entering payment information manually into their EMR. By collecting all payments directly into their EMR, Performance Pediatrics saves even more time with automated posting and reconciliation for all payer and patient payments while improving accuracy in the payment process.

BUSINESS RESULTS

By using InstaMed’s integrated Claims and Remittance solutions with their Office Practicum EMR, Performance Pediatrics now receives payer payments two to three times faster – reduced from 20-45 days to 7-21 days. This enables staff to bill and collect payments from patients more quickly as well to increase cash flow, allowing it to succeed as a start-up practice. Additionally, with the ability to streamline its claims processing and efficiently collect, post and reconcile payer and patient payments, Performance Pediatrics has improved claims and payment accuracy while saving 40 hours of administrative work per week.