Success Stories: Performance Improvement

Nordic partners with leading children's health system to optimize charge capture processes

Project Scope Overview

A leading children’s health system with more than $2 billion in annual net revenue was seeking a partner to boost revenue through a series of engagements spanning the entire revenue cycle. Nordic was chosen to partner with the health system in their efforts, focusing specifically on charge capture and denials improvements.

With the COVID-19 pandemic taking hold just weeks into the implementation, the team shifted to a completely remote model of project delivery with a goal to achieve charge capture-related net revenue improvement of more than $9.3 million annually.

Results

  • Improved overall recurring net revenue by more than $17M
  • Optimized perioperative charge methodology to align with resource consumption and procedural acuity while remaining competitive
  • Enhanced back-end efficiency of Revenue Guardian build
  • Automated charge creation from clinical documentation and emergency department
  • Eliminated reliance on third-party software, reducing vendor spend

Partnering with leaders and stakeholders from across the organization, including revenue integrity and clinical departments, Nordic implemented an array of initiatives that included charge router enhancement, Revenue Guardian rule creation, charge methodology optimization, and cost savings. This resulted in more than $17 million in recurring net revenue improvement, exceeding the goals of the project. Nordic created tailored solutions for the health system while actively transferring knowledge, minimizing ongoing maintenance, and avoiding workflow disruptions.

Implementation Details

  • Opportunity Discovery - Through propriety analyses, identified key areas of charge capture enhancement to optimize net revenue
  • Stakeholder Interviews - Engaged stakeholders from affected departments to establish relationships and uncover additional, unseen opportunities
  • Opportunity Validation - Worked with stakeholders to test the validity of identified opportunities, receive buy-in for solution implementation, and model the revenue impact of the issue
  • Solution Creation - Collaborated with initiative champions to create solutions that would alleviate underlying issues, require little maintenance, and minimally disrupt established processes
  • Solution Implementation - Created custom solutions for each initiative and took on any build, education, or process-related items while transitioning each solution to a designated client owner for ongoing insight
  • Post-Implementation Monitoring - Post go-live, monitored downstream data points to confirm implemented initiatives were working correctly, staff were adhering to new processes, and net revenue was increasing
  • Benefit Tracking - Tracked revenue associated with initiative-related charges and compared revenue to a baseline period; benefit figures were reviewed and validated by the project sponsor, project executive, and CFO

 

The Nordic team acted as an extension of our revenue integrity team, which greatly expanded our reach and reputation. They built trusting relationships with department and IT staff and leadership that helped us manage the change curve of new process implementation throughout the project. Nordic was so thoughtful about workflow and training that it is almost like we’ve had these tools for years – even though it has been a few months! We’ve gained millions in net revenue and are confident we will continue to see these returns for years.

 

DIRECTOR OF REVENUE INTEGRITY, LEADING CHILDREN'S HEALTH SYSTEM