A physician-led, multi-specialty medical group serving the greater Chattanooga area. With more than 120 healthcare professionals across over 33 locations, it delivers a full spectrum of preventive and specialized care and stays on the cutting edge of the industry.
Too many denials were taking root before a claim was ever submitted, at the front end of patient access. Two challenges stood out.
IKS Health deployed its patient access solution with autonomous eligibility and benefits verification to map benefits to each planned service before the visit. A longitudinal patient profiler protected registration integrity by detecting and correcting mismatched or missing data in the registration feed, heading off denials at the source.
From the first quarter, eligibility and benefits verification ran on every scheduled visit, with liability estimation for specific patient groups, and prior authorization was handled through a payor knowledge base for the visits where it applied.
Catching issues before the claim went out protected revenue and showed up in a reportable decline in denials. Front-end originated denials fell from $1M in the first quarter to $431K by the third, and weekly and monthly reports kept the results visible while the solution delivered registration integrity, eligibility and benefits verification, and liability estimation value.
>$550K
58%
To learn more about the IKS Health patient access solution, contact us today.