Revenue partnership navigates reimbursement, reduces days in A/R from 142 to 36
Valley Day and Night Clinic has five locations spread across the Rio Grande Valley and Laredo in southern Texas. All the clinics are dedicated to providing affordable, reliable quality care to about 15,000 patients every month. Fifteen practitioners serve the five locations, and for 12 years in a row, the clinic has received the Reader’s Choice Award for Best Clinic from The Brownsville Herald newspaper. Almost by accident, the practice learned that updating billing practices and procedures could help guarantee the financial security required to better serve its community.
“Our model is walk-in,” said clinic Chief Operating Officer Melissa Jareño. “We provide a combination of family practice, workers compensation and industrial medicine, including pre-employment physicals, and drug testing. We perform therapy on workers’ comp patients. We are kind of a one stop shop. We have a full lab, EKG, UA, X-ray, and more.”
Solving healthcare reimbursement issues the practice didn’t know it had
Having used a Greenway Health EHR and practice management for nine years, Valley Day and Night Clinic was researching Greenway Community, Greenway Health’s population health tool, to help them assess patient risk and improve outcomes. In the process, the practice discovered that its billing practices were leaving money on the table. “A Greenway representative came down to talk to us,” Jareño said, “and before he did, he remotely accessed our system with our permission and performed an audit. He identified that our internal billing team had been down-coding some of our stats, saying that they didn’t feel they were Level 3 or Level 4, even though Greenway Prime Suite had identified them as such.”
"I am able to focus on efficiencies because I am no longer worried and focused so much on billing and fighting to bring in every dollar ..."Melissa Jareño, COO, Valley Day and Night Clinic
The practice realized that changes in medical billing procedures and protocols were occurring so quickly, it was extraordinarily difficult for its billing team to keep up. “We needed to partner with someone who had the resources to consistently train and educate employees in order to stay on top of everything.”
Greenway Revenue Services conducted an analysis to identify practice challenges with billing and coding. The result suggested that the practice was leaving up to $1 million of uncollected revenue on the table each year. That’s when Valley Day and Night chose to partner with Greenway Revenue Services.
The first step for clinic staff was the provision of 50 hours of training, provided on-site and via webinars. A Greenway Revenue Services trainer also came in and evaluated the practice’s entire process, including front desk, providers, nurse’s stations, and billing department, providing a report on every area. The report showed how the practice could optimize both processes and Greenway tools for more timely and accurate billing. “I still carry that report around in my notebook that I use daily,” Jareño said.
Progress toward a healthier bottom line
Since partnering with Greenway Revenue Services in April of 2017, the practice has seen continuous improvement. “Days in A/R are shorter,” Jareño said. “Our denials went from over $100,000 per month to under $19,000, and sometimes down to $15,000. Greenway Revenue Services address those denials quickly. They let us know that, for instance, 80% of our denials are eligibility denials and they’re from one clinic. Greenway can then go in and train this clinic’s staff on how to do better.” In addition, the practice’s average days in A/R fell from the 142 to 36.
Part of this success has to do with the Greenway Revenue Services team’s accessibility. “They make us feel like we are their only account at the moment,” Jareño said. “I have two or three different people that I can reach out to, and I normally have a response in under one hour. And the knowledge transfer that they bring is another really great thing.” The Greenway Revenue Services team relieves the practice of trying to keep up with ever-changing codes and requirements.
Relief from a significant portion of the billing burden has opened the door for additional efficiencies at the practice. “I have decreased my payroll by 12%,” Jareño said. “Not all of that is GRS, but a lot of it is. I am able to focus on efficiencies because I am no longer worried and focused so much on billing and fighting to bring in every dollar while fearing that my billing department was having trouble keeping up with the workload, and keeping up to date on billing changes.”
According to Jareño, the practice bottom line continues to grow. Valley Day and Night Clinic now relies on Greenway Health tools for EHR, practice management, billing, and population health (through Greenway Community). Jareño finds tremendous efficiency in working with one vendor across multiple areas, and it only heightens Valley Day and Night Clinic’s sense that Greenway Health is more than an outside vendor, but a partner that functions as an extension of the practice.
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