Expanding the footprint, service line and revenue for a multispecialty surgical group
– Dallas/Fort Worth Market

Client Description

A growing and diversified surgical group that provides services to residents of the DFW metroplex and will soon be expanding into the Houston area. They offer a variety of services that include General Surgery, Acute Care, Trauma, Upper GI & Bariatric Weight Loss Surgery, Vascular Surgery, Colorectal Surgery, Robotics Surgery, and Surgical Oncology which includes Colorectal, Pancreatic, and Esophageal cancer.

Providing care to over 20,000 patients with more than 15 office locations and affiliations with 23 hospitals including THR, HCA, Baylor Scott and White and Methodist.

Challenges

  • Need for a scalable RCM and process model allowing practice to add providers, increase patients, open more locations, expand to additional cities, and increase the number of hospital affiliations
  • Establish a de novo ASC/OBL with streamlined policies and procedures
  • Maintain and increase profitability as volume and service lines increase
  • Standardize revenue processes and simplify RCM through a holistic approach, allowing practice to stay privately funded

Solutions

  • Provide end to end revenue cycle management services including:
    • Prior Authorization
    • Coding and CDI best practice
    • Claim scrubbing and submission
    • Payment Posting
    • AR and Denial Management
    • Bank Reconciliation
    • Monthly ROI Analysis
  • Provide feedback and suggestions to physician and clinical staff as it relates to clinical documentation improvement (CDI)
  • Establish weekly and monthly meetings for operations and business review for collaboration, accountability, and transparency
  • Allow seamless growth and ability for the practice to scale through process improvement and RCM support

Business Impact

  • More than doubled the count of healthcare providers with a 4x increase in practice revenue
  • Established a new ASC/OBL that is cash positive within 90 days of inauguration
  • Expanded services and hospital affiliations into a new metropolitan area
  • Providing metrics and RCM trends giving the practice insight to make well-informed decisions
  • Bridging the gap between business and medical care allowing the practice to focus on patient care and growing their business
  • Decreased staff costs while maintaining quality assurance and regulatory compliance­

Metrics

  • Claims processing: 48–72-hour turnaround time
  • A/R > 90 days: <10%
  • Prior Authorization approval rate: 99%
  • Coding accuracy: 99%
  • First Pass Resolution Rate: 95%
  • Denials Percentage: <5%

Client Testimonial

How has your business relationship with Allyhealth Solutions been instrumental to growing your practice?

Our relationship with Allyhealth Solutions started over three years ago beginning with revenue cycle management/billing support, now extending to coding, prior authorizations, demographic entry, and document indexing. They are exceptional at being transparent, efficient, and excel in customer service which is the driving force surrounding high fidelity to our billing operations. Our relationship is highly bi-directional with all processes and systems being fluid and spearheaded by their leadership team. They provide a turnkey solution to RCM which has not only corrected the billing deficiencies prior to onboarding but have also been instrumental to our growth by providing deliverables that support our expansion.

Rob San Miguel, MHA
VP of Operations