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Case Study - A Two Provider Ophthalmology Practice With Optical.


Client is a two (2) provider ophthalmology practice with an optical department that had trouble finding experienced billing staff in their respective geographical area.


the challenge


The front desk staff were poorly trained on their practice software and the practice had ineffective and insufficient eligibility and benefit verification processes in place. Charges were not processed in a timely manner. Front desk staff lacked experience and insurance plan understanding. The practice had never reviewed monthly reports with key performance indicators.

The Action Taken


Agnite worked closely with the provider and managers to implement consistent daily workflow and reconciliation processes. We also communicated with the front desk daily to ensure all issues were reviewed and resolved and to continue to improve their overall knowledge of the primary carriers. Agnite worked all outstanding denials and proceeded to systematically work all carriers with the shortest timely filing deadlines. Focus was placed on the patient accounts receivables to reduce bad debt and ensure timely patient statements and follow-up.

Before


  • Insurance Accounts Receivable % current aging bucket: 32.63%
  • Insurance Accounts Receivable % older than 90 days: 55.05%
  • Patient Accounts Receivable % older than 90 days: 43.08%
  • Days in AR: 34.2

After


  • Insurance AR % current aging bucket increase 32.63% to 86.34%
  • Insurance AR % older than 90 days decreased from 55.05% to 4.84%
  • Patient AR % older than 90 days decreased from 43.08% to 11.62%
  • Days in AR: 16.4 days
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Dallas, TX 75231

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