Success Stories: REVENUE CYCLE: ADVANTAGECARE PHYSICIANS

AdvantageCare Physicians partners with Nordic to optimize Epic's Real Time Eligibility functionality

Project Scope Overview

  • Client Corporate Headquarters: New York City
  • Project Dates: March-Dec. 2016
  • Number of Locations: 36
  • Number of Physicians: 450
  • Number of Care Teams: 165

The Nordic Team

  • 1 engagement advisor
  • 1 RTE senior consultant with 6 years of experience on Epic’s Real Time Eligibility team

Results

  • Decreased eligibility and referral denials by 47 percent
  • Achieved a greater ability to validate coverage for eligibility and ensure accuracy at the plan level
  • Reduced operational expenses by 32%
  • Trained director of patient access to serve as the primary RTE expert for AdvantageCare Physicians

In March 2016, AdvantageCare Physicians engaged Nordic to optimize Epic's Real Time Eligibility, a functionality that improves revenue cycle efficiency by automating communication between payers and the EHR. With Real Time Eligibility, patient registration data that used to be collected manually is available instantly, resulting in fewer claims submitted with invalid data.

Nordic set out to improve communication between AdvantageCare Physicians' insurance payers and the EHR, with the ultimate goal of decreasing denials, reducing operational expenses, and improving patient satisfaction.

To achieve this goal, Nordic's senior consultant partnered with AdvantageCare Physicians' director of patient access to define requirements and prioritize needs for payer plan mapping and copay filing. By spending 600 hours within a nine-month time frame, Nordic optimized 15 existing payers and three previously non-enabled payers for payer plan mapping and copay filing.

The collaboration resulted in 47 percent fewer denials, as well as a 32 percent reduction in operational expenses. Nordic also trained AdvantageCare Physicians' director of patient access to serve as the primary RTE expert for the organization by the end of the engagement.

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