With eSolutions’ clearinghouse, CommuniCare quickly decreased denial rates and days in A/R. Bad debt write offs dramatically declined while revenue rose 300 percent.
Reduced denial rate
Reduced A/R days
Increased net revenue
CommuniCare Health Centers began in the 1970s in a San Antonio, Texas, Catholic church to help children suffering from diphtheria. Today, CommuniCare Health Centers is a large, full-service primary health system with locations in three counties in the San Antonio area.
In 2012, CommuniCare lacked adequate support from its clearinghouse vendor. First, the vendor didn’t have the capacity to properly bill Medicare, creating a year-long reimbursement lag. Securing electronic remittance advice and payments through its clearinghouse was also challenging. Additionally, the health center couldn’t use the same clearinghouse for medical and dental claims and eligibility verification, and eligibility problems created more denials than any single issue. With a wide variety of specialty providers, CommuniCare needed a way to streamline claims of its many provider types with one clearinghouse.
The Solution – eSolutions’ Clearinghouse
In early 2013, CommuniCare switched to eSolutions’ clearinghouse, ClaimRemedi, which conveniently integrated with NextGen, the health center’s practice management system.
Quiara Sherrard, CommuniCare’s Chief Revenue Officer, said they chose ClaimRemedi for two main reasons – customer service and seamless technology integration. “ClaimRemedi had a solution that worked well with our NextGen PM system and provided more functionality than our previous clearinghouse,” Quiara said. “They are by far a leader in customer service and have such a great understanding of the unique billing needs of community health centers.”
After using ClaimRemedi’s remits functionality, CommuniCare discovered the ease of posting payments back into NextGen, which improved denials and days in A/R. ClaimRemedi’s eligibility verification feature quickly slashed rejections and denials. The integration between NextGen and ClaimRemedi resulted in significant time savings. No more contacting multiple payers via phone or visiting payer websites to hunt down data thanks to ClaimRemedi’s unique technology that automates this process.
Soon after switching to ClaimRemedi, CommuniCare experienced tremendous benefits. The annual average denial rate decreased by 16 percent. The average days in A/R was reduced by 62 percent, down from 32 days to 12 days. After the first year using ClaimRemedi, bad debt write-offs decreased $300,000. As CommuniCare continues growing, its team is confident it has effective technology to ensure it will be a top-performing health center for years to come.
The CommuniCare team is certain it made the right choice to switch. “I believe we can attribute the efficiencies we have been afforded by ClaimRemedi to an increase of revenue by 300 percent,” Quiara said.