About the OB/GYN network
One of the largest parent organizations for a consortium of practices specializing in obstetrics and gynecology across the Southeast. With more than 200 physicians and over 40 certified nurses, the network serves patients across more than 40 locations, including satellite offices and a central business office.
The denial pressures weighing on collections
The network’s collections were under pressure from denials and a disruptive external event.
Catching denials early and tailoring appeals to each payer
IKS Health started by reviewing the network’s top denial reasons so problem claims could be caught before they were ever billed to insurance. Working closely with the client, the team:
- Flagged claims that were being incorrectly processed and denied as out of network, then surfaced quickly so the issue could be corrected at the source.
- Integrated them into IKS Health denial management solution, reducing denials that stemmed from incorrect patient information capture and cleaning up minor errors that had been weakening appeal outcomes.
The results after strengthening denial management
Across the twelve months period, the partnership reduced denials, recovered collections after the cyber attack, and improved the economics of every visit.
$3.1M
Cost savings over the same period
8%
Higher gross collection ratio from a lower denial rate
$85+
Increase in net payments per visit
