Revenue Cycle Management - From the Brink to Stability

Background:

A community-based mental health organization in Georgia, was grappling with financial losses and on the verge of shutting down. Despite a devoted client base and essential services, discrepancies in billing processes had led to a critical deficit.  

Challenge:

This organization was struggling with under-coded services, unsubmitted claims, and a backlog of denied claims. The complexity of billing for behavioral health services had overwhelmed their in-house team, leading to significant revenue leakage.  

Solution:

Evia stepped in with a comprehensive Revenue Cycle Management strategy. We began by conducting an exhaustive audit of past and present billing processes. Within the first month, our team identified over $100K in unbilled services due to coding inaccuracies. By implementing our RCM support, we corrected these discrepancies, resubmitted denied claims, and set up a stringent follow-up process for future claims.  

Outcome:

Within 60 days, Evia recovered over $100K in revenue. This immediate cash infusion alleviated financial pressures, allowing the organization to avoid closure. Our ongoing management has ensured sustainable financial practices, positioning them for growth and enabling continued essential services to their community.