Our client was a Top 10 hospital-based specialty billing company, when it partnered with us in 2011. The partnership goal was to power in to the Top 3 of the industry in 7 years. It was to be achieved through cost savings and performance improvement. A multi-wave strategy was set in motion.
This involved lift-and-shift of low-value data entry functions, followed by high-impact coding functions, within the first six months. Within 18 months, migration of all back and middle end functions was complete, for all end clients being onboarded by Quintessence from Day 1.
Impact on the bottom line: US $ 3m per year
This ran in parallel to Wave 1, with building automated coding tools (Codessence) to drive coding productivity up (by 60%), and reduce first-pass denials to low single digits. The knock-on benefits were shared with the client partner by way of a 20% fee cut.
This focused on developing interfaces to end-customer platforms, and eliminating ‘multiple touches,’ resulting in a ‘one-touch billing’ environment. Our workflow solutions integrated the end customer, the client partner and Quintessence, in a seamless fashion, eliminating costly interventions to the front-end, whilst providing process flow visibility.
Finally, Quintessence built analytics to provide intelligence on claim resolution, denials by payers, front-end edits, and normal distribution charts for inventory, the likes of which as a client practice, had never been provided.
Reimbursement increased 4% CAGR YOY for the last three years and ‘cost to service’ was down almost 8%. The resultant margin cushion and the performance track record, helped the customer gain new business and grow to enter the Top 3 in the segment, within just