Samaritan Medical Center Achieves 12% Boost in Cash Collection

CASE STUDY

CLIENT: Samaritan Medical Center (Watertown, New York)

CLIENT INFORMATION: Samaritan Medical Center is a not-for-profit community medical center, offering a full spectrum of inpatient and outpatient healthcare services. From primary and emergency care to highly specialized medical and surgical services, such as cancer treatment, neonatal intensive care, behavioral health and addiction services, and imaging services, Samaritan Medical Center and its team of healthcare professionals proudly serves the medical needs of our civilian and military community. Quality, compassion, and safety serve as the fundamental tenets of exceptional care delivery at Samaritan.

OPPORTUNITY: Samaritan Medical Center faced challenges in their revenue cycle billing operations as they operated without a clearinghouse. As a result, the organization had to rely on sending claims through four different methods. These methods included direct submission to Medicare, Medicaid, Blue Cross/Blue Shield, and commercial insurance providers –  notably, without a claim scrubber in the process.

The Samaritan team evaluated multiple clearinghouse providers and ultimately selected Quadax. They were especially impressed by Quadax’s Xpeditor™ claims management technology, particularly its Decision Intelligence capabilities. Chris Hochgraf, Director of Revenue Cycle, cited the Decision Intelligence tool’s trend analysis and in-depth insights as the key factor in their decision. “Quadax stood out because their data goes beyond individual pieces of information and offers a comprehensive view. It allows us to identify areas for improvement and chart a path to increase our reimbursement.”

Decision Intelligence (DI) by Quadax incorporates tools, technologies, and strategies that help turn raw and disorganized data into purposeful information.  DI helps healthcare organizations acquire meaningful information with real-time insights to efficiently understand complex revenue cycle data and be alerted to key events, trends, customer behaviors, correlations, and patterns for informed decision-making. Leveraging actionable data allows organizations to quickly uncover solutions and achieve improved business outcomes, be more effective and efficient, and positively impact reimbursement.

ACHIEVING SUCCESS: Samaritan Medical Center Achieves Quicker Reimbursements and Time Savings with Xpeditor and the Quadax Clearinghouse

Today… Samaritan Medical Center is experiencing faster reimbursements and saving time after implementing Xpeditor and the Quadax Clearinghouse. Hochgraf stated, “During a challenging period when we faced staff shortages, Quadax helped us take a proactive approach, mitigating issues at the start of the revenue cycle. This has resulted in reduced reimbursement turnaround time and improved cash flow.”

  • Xpeditor’s claim edits and other management tools enable Samaritan Medical Center to send cleaner claims, leading to fewer rejections and denials giving Samaritan a 12% boost in cash collection and a 12% reduction in accounts receivable from January to July 2023.
  • Xpeditor and Decision Intelligence reports offer Samaritan Medical Center visibility previously unattainable, facilitating a more proactive approach to managing the revenue cycle and providing a road map of improvement for their organization.
  • Samaritan Medical Center is maximizing the benefits of Xpeditor technology and is currently in the process of setting up an Automated Secondary Process (ASP). In the past, without a Clearinghouse, their billers struggled to find the time for secondary claims and wrote off substantial amounts of money. However, Samaritan is eagerly anticipating going live with ASP, having the primary claim sent out seamlessly, the corresponding 835 received, and then automatically linked to it to create the secondary claim—eliminating the need for human intervention. This advancement is expected to significantly increase reimbursement for the organization and save even more staff time.

Words of Wisdom from Client: “To those embarking on a similar journey, I cannot stress enough the importance of involving all the stakeholders in the implementation process. The more people you can include, such as billers, coders, and all members of the revenue cycle team, the better the alignment and collaboration you will have when you go live.

It was Quadax’s exceptional customer service team that truly turned things around for us. Their unwavering support enabled us to make informed decisions based on best practices, meticulously guiding us through each step of the process. They helped us identify opportunities at the back end, addressing root causes and resolving issues. Quadax went above and beyond their contractual obligations, investing a significant amount of time and effort to deliver a superior level of service for our success.”

A Year in Review: Pella Regional Health Center

CASE STUDY

CLIENT: Pella Regional Health Center (Pella, IA)

CLIENT INFORMATION: Pella Regional Health Center is a private, non-profit provider of health care, named one of the Top 20 Critical Access Hospitals in the country for overall quality. Pella Regional is one of only twelve 5-star hospitals in the state of Iowa, staffing 25 acute care beds and over 90 physicians.

OPPORTUNITY: In the summer of 2020, Pella Regional Health began evaluating clearinghouse vendors, seeking improvement in product functionality and in service support. Karri Woody, Pella Regional Director of Revenue Stream, had four key priorities:

  • Decrease days in AR
  • Decrease denials and gain efficiencies with secondary claims
  • Streamline the remit process
  • Partner with a vendor whose products are matched by their level of service and support

After evaluating several vendors, Pella ultimately chose Xpeditor by Quadax, the Best in KLAS Claims Management solution. Pella Regional officially launched with Quadax in November 2020.

Xpeditor offers impressive claims management capabilities, including a library of edits that results in a 99.6% first-pass acceptance rate. But, it’s the way Quadax collaborates with people that really stands out. As Karri Woody observed, “We chose Quadax because they are able to provide us with the solution we were looking for and a dedicated staff to help us get there.”

ACHIEVING SUCCESS: Each of Pella’s priority areas saw direct improvement!

15% decrease in days in AR:

  • Xpeditor reports offer Pella Regional visibility previously unattainable, facilitating a more proactive approach to managing the revenue cycle.

Decrease denials & gain efficiencies with secondary claims:

  • Xpeditor’s Denial Management systems organizes the denials that do occur for efficient follow up and effective revenue recovery.
  • Xpeditor’s superior claim edits and other management tools enable Pella to send cleaner claims, leading to fewer rejections and denials.
  • Xpeditor automates secondary claim creation and processing.

Streamlined remit process:

  • Increased volume of electronic remittance advice (ERA) to 98% of all remits received, for faster posting with less chance of manual error.
  • Standardized reports and EOBs based on payer ERA allow Pella Regional representatives to review them quickly and easily.

Partnered with a vendor whose products are matched by their levels of service and support:

  • Through implementation, the system was tailored to Pella Regional’s needs, and end-user training was provided to the entire Pella Regional team.
  • Ongoing service enables Pella Regional to continue to make the most of the Xpeditor system.

Testimonial from Client: “All of our staff was trained by Quadax; they provided multiple follow-up sessions that allowed our staff to ask questions. We communicate with our Quadax service team multiple times a month on various questions relating to opportunities or missing remits. I would describe the Quadax support team as amazing!”