Increased collections and improved first pass billing ratio with IKS Health denial management solution

About the women's health network

A comprehensive network of fast-growing OB/GYN physicians, breast health centers, high-risk pregnancy centers, laboratories, urogynecology practices, and fertility centers. This community of progressive health professionals is focused on putting women first, connecting them to the total care they need to lead healthier, happier lives.

Where denials were draining collections

Denials were eroding collections across the network, and the revenue cycle showed the strain in several places. The challenges included:

A dedicated denial management task force

IKS Health set up a dedicated denial task force to run root cause analysis on denials and focus squarely on bringing the denial rate down. To lift the first pass billing ratio, the team implemented better processes and introduced edits with clear checks and balances, so claims went out clean the first time. IKS Health also deployed a region-wise team organized by payer and specialty, with clear ownership, to accelerate account receivables (AR) liquidation.

Results driven by IKS Health

Across the year, the network increased collection, reduced denials, and cleared aging receivables faster. The clean claim ratio also improved from 94% to 97%, bringing it in line with industry standards.

3.1%

Increase in net collection ratio, from 90% to 93.1%

14.2%

Increase in first pass payment ratio, from 65.5% to 79.7%

3.5%

Reduction in denial rate, from 18.5% to 15%

11.6%

Reduction in AR over 90 days