From Cash Flow Crisis to Financial Clarity:

The Problem: Patient Care Without Cash Flow 

The Kentucky clinic had every reason to believe they were on the right track. Patients were filling their appointment slots, and feedback was consistently positive. However, cash flow issues persisted, leaving the clinic's leadership puzzled. Why wasn’t the practice's income matching their patient volume? 

An Unfortunate Discovery

The clinic had trusted their billing company to handle claims, patient billing, and credentialing. They believed everything was in good hands. Unfortunately, they were wrong. The billing company wasn’t doing its job properly. Claims weren’t filed on time, bills weren’t sent accurately, and credentialing was mishandled. The result? Millions of dollars tied up in accounts receivable and lost revenue from visits that couldn’t be billed. 

Identifying the Challenges: Mismanaged Claims and Credentialing 

It became clear that the billing company had neglected crucial aspects of the revenue cycle. The team prioritized their own convenience over the clinic’s financial health. They failed to: 

1. File claims properly: Incorrect and delayed submissions led to excessive denials and lost revenue. 

1. Bill patients accurately: Mistakes and omissions meant the clinic wasn’t paid for many services. 

1. Manage credentialing: New doctors weren’t credentialed correctly, leading to unbillable patient visits. 

This mismanagement left the clinic in a dire financial situation. They faced millions in outstanding accounts receivable, increasing denials, and a growing cash flow crisis. 

HRG’s Transparent Approach: Working in Your System, Not Ours 

HRG stepped in with a promise of transparency and partnership. Unlike the previous billing company, HRG does all work directly in the client’s system. This approach allows practice leadership to see exactly what’s happening in real time. You get full visibility into your claims, A/R , and credentialing status. 

Additionally, HRG holds monthly meetings with the practice’s leadership team, ensuring open communication and timely updates. This level of transparency and communication fosters trust and prevents issues from going unnoticed. 

OPTIMIZING REVENUE CYCLE MANAGEMENT: A MULTI-STEP SOLUTION 

When HRG took over, we focused on three core areas: 

1. Improving Claims Management and Workflow Efficiency

HRG started by streamlining the clinic’s use of its existing EMR system. We introduced better use of the “job” system (automated workflow processes) to ensure timely claim filing. Our team also worked closely with the clinic’s staff to develop effective verification strategies tailored to their patient base. This led to faster claim processing and reduced denials. 

2. Properly Credentialing New Doctors 

Uncredentialed doctors cost the clinic revenue every time they saw a patient. HRG took immediate action to resolve this issue. We began the credentialing process for all new doctors, ensuring they were approved by every payer the clinic worked with. This step alone helped recover significant potential revenue. 

3. Cleaning Up Accounts Receivable 

Real Results: Measurable Improvements in Revenue and Cash Flow 

The results of HRG’s intervention speak for themselves: 

• 20% Reduction in Accounts Receivable so far: Outstanding balances decreased dramatically, freeing up significant cash flow. 

• 35% Reduction in Denials: By streamlining claim submissions, we reduced the denial rate, increasing successful reimbursements. 

• 40% Improvement in Collections: Accurate billing and efficient follow-up boosted the clinic’s collections significantly.