The Challenge
Getting a good grasp on the Revenue Cycle Management was one of the biggest challenges for a large Dental Service Organization (DSO) in the state of Tennessee, USA. To understand the outstanding Accounts Receivable from patients and insurance companies across multiple practice locations (more than 100) and also across multiple heterogeneous Practice Management Systems (PMSs) (also more than 15 different PMS vendors) was a huge challenge.
Even though the data was available at each practice location, seeing it all in one aggregated place to get a bird’s eye view of the financials for the DSO management team at their HQ was a huge challenge.
Managed by the internal IT team with support from multiple IT vendors was also another challenge
The Solution
Our team proposed and developed a SaaS solution that managed
- Automated insurance verification which updated the patient records in the PMS
- Provided Claims-related information (status & amount) for each patient by location
- Processing the Payment from the Insurance companies by automating the ACH deposits
- And finally, manage the KPI dashboard as per the customer’s specifications.
- Discovery Phase: Showcasing the proposed solution, leveraging Figma, and spending most of the time to understand the business flow and customer pain points that should be addressed as a priority
- Implementation: Ensuring our solution is integrated with the existing PMS and other systems that the DSO is already using, without having to make any major changes in their day-to-day business.
- Training: Provide training to individual key and power users and ensure their feedback is taken into account, along with the management inputs on the vision of what needs to be achieved.
The Results
The successful deployment of our solution led to measurable improvements in several key areas.
The improvement in efficiency for the customer was clearly visible in terms of the time saved while doing the insurance verification for the front desk personnel. As the entire process is now automated, the office manager now has more time to focus on the patients that he/she needs to attend to at the clinic. There is also the time saved after the clinic is closed to reconcile the insurance verification and switching between multiple insurance portals, etc.
The other major area of improvement is the processing of checks and bank transfers that happen once the insurance payments come through, but the reconciling of payments for each patient via the EOBs (Expression of Benefits) from the insurance portal used to take a long time. Now, that is also fully automated. The work for the accounting department personnel is only to review and verify the automated transactions posted to the general ledger.
One of the useful tools for the management team at the DSO is the KPI Dashboard, which helped them visualize the production, collection, A/R, new patients, appointments, claims, and other important KPIs to measure the team’s productivity as well as the financial health of the practice. They were now able to view aggregate numbers across all their locations, by providers, by carriers, and so on. The custom dashboarding and report generation feature also helped individual CxOs to keep track of their own data sets.
Quote from the Client:
"Working with Webstrail was smooth and less of a friction compared to our previous experience with other IT vendors. We saw a lot of value added to what we set out to build because of the immense domain knowledge that the team at Webstrail comes with.”
Next Steps
If you would like more details on these case studies or wish to feature your own success story, please contact Sujith Aranghat or set up a consultation with our sales team.