The Power of Comprehensive RCM Services in Thompson Cardiology Clinic's Success Story
Outsourcing medical billing and credentials to **Code Credentia** allowed Thompson Cardiology Clinicto eliminate critical billing administrative burdens, recover aged claims, and drive substantial growth. Below, we detail the challenge face by the practice and the direct solution delivered by Code Credentia.
The Challenge
Thompson Cardiology Clinic was struggling with a high claim denial rate of 18% due to outdated ICD-10 coding practices and complex cardiology modifier combinations (such as -26, -TC, and -59). Their in-house billing team was overwhelmed by the frequent updates in Medicare local coverage determinations (LCDs), resulting in delayed payments and lost revenue.
The Solution
Code Credentia deployed a dedicated team of AAPC-certified cardiology billing and coding experts. We integrated our real-time claim scrubbing technology with their existing EHR, updated their fee schedule to reflect current payer rates, conducted regular provider documentation audits, and took charge of insurance credentialing for their new associates.
Through the Partnership with Code Credentia, Thompson Cardiology Clinic Achieved Remarkable Results:
- ✓Reduced claim denial rate from 18% to a record low of 1.8% in under three months.
- ✓Accelerated the reimbursement cycle, reducing average Days Sales Outstanding (DSO) from 45 to 31 days.
- ✓Boosted overall monthly net collections by 32%, recovering thousands in historically lost claims.