Case Study: Cordant Health Solutions
Due to the unique nature of Cordant’s business, they have a significant number of “self-pay” patients. Many of these patients actually have insurance coverage that could be billed for their services, but in some cases, the patients are in treatment for substance use disorder. As a result, gathering eligibility and insurance coverage information for these patients can be very labor-intensive and remain unsuccessful. Cordant had also found that the traditional methods for acquiring this important information were not particularly effective.
Being unable to identify valid insurance coverage for a portion of patients causes a loss in revenue collected as well as an increase in operating expenses due to the attempts to gather correct coverage information. The Cordant team recognized an opportunity to improve their cash collections by integrating more effective insurance discovery capabilities into their revenue cycle management (RCM) process.
To make insurance discovery easy for XIFIN clients, FrontRunnerHC insurance
discovery capabilities were integrated with the XIFIN RPM solution. Cordant was already using XIFIN RPM for revenue cycle management and met with the team at FrontRunnerHC to learn more about their insurance discovery capabilities. FrontRunnerHC now provides Cordant with access to real-time patient eligibility data by accessing a variety of databases to cross-reference patient identification records, and insurance and eligibility information, helping them successfully bill and collect on more claims.
Due to some of the unique aspects of Cordant’s business, they needed XIFIN and FrontRunnerHC to develop some custom workflows, which extended their integration beyond the typical 30-day implementation to between 60 and 90 days. Cordant also took a staged approach to their roll-out by only turning on a few denial codes at a time to get a feel for the message responses that they would receive. They activated additional denial codes over time.
The Cordant Revenue Cycle Management team decided to manage the
FrontRunnerHC insurance discovery solution themselves, rather than having it managed by their IT team. While this may not be the best approach for all organizations, it has helped the Cordant team of users really understand the details of the system to maximize its value.
Cordant is measuring the success of this integrated approach to insurance discovery by tracking the reduction in denial rates as well as the increase in cash collected from self-pay accounts. Just a few months after implementation, they were already seeing an increase in coverage for the segment of patients previously categorized as self-pay. They also went back and ran older accounts that had been in “delinquent” queues to capture updated coverage data, where available.
To date, they have seen several hundreds of thousands of dollars in additional cash collections. They have also been able to re-task some of their team members to focus on more complex denials rather than chasing down eligibility and coverage data. Because some of the patients the Cordant team works with are moving between locations, for example during treatment, they run patients classified as self-pay twice. They run them again before they send out their final statement to make sure to take advantage of any new or updated information.
According to Keith Truax, vice president of operations at FrontRunnerHC, Cordant has seen great results in large part to their executive team’s engagement in the initiative. He noted, “Cordant’s recipe for success is that their leaders saw the value of the initiative from the beginning and stayed engaged through the implementation process. They remain involved in refining the strategy based on the results seen to date.”
Going forward, the Cordant team expects to see a reduction in denial rates, resulting in even more revenue, collected faster. They are actively engaged in fine-tuning their strategies to maximize the value earned through their investment in the integrated XIFIN FrontRunnerHC solution.
About FrontRunner Health Care
FRHC has partnered with XIFIN to seamlessly integrate their Patient Remedi Insurance Discovery application with XIFIN RPM, delivering valid insurance coverage for self-pay patients and reducing the staffing expenses associated with discovery.