CASE STUDY
HOSPITAL PATHOLOGY ASSOCIATES, P.A.
A tailored RCM partnership that boosted efficiency and financial success through automation and transparency.
Hospital Pathology Associates, P.A. (HPA) is a large pathology group practice in Minnesota with broad subspecialty diagnostic expertise in clinical and anatomic pathology.
With over 85 employees, including 36 pathologists, services range from routine surgical pathology to complex molecular next generation sequencing.
HPA needed a billing partner to help resolve operational challenges and deliver a steady cash flow.
Additional goals included:
- Consistent charge posting and efficient collection processes.
- Transition from paper workflows to electronic systems.
- Achieve complete transparency by providing online access to key results.
- Ensure the implementation of critical processes, including accession tracking, denial management, and payer reconciliation.
- Operational goals, including advanced reporting, steady cash flow, and innovative solutions.
VENDOR SELECTION PROCESS
Over a period of six months, HPA evaluated at least seven well-known national billing service providers in detail.
Evaluation criteria included:
- Sub-specialty expertise with a cultural fit.
- Overall cost structure.
- Provider interface development and support for workflow automation.
- Maintenance and integration with the internal HPA coding department and staff.
- Computer assisted coding module, enabling remote coding.
- Real-time web-based reporting with extractable information supporting revenue cycle analytics.
- A track record of timely and effective collections.
During this process, Health Prime brainstormed solutions and crafted workflows with HPA. Detailed workflows were developed to illustrate how Health Prime could work with each HPA provider location, Lab Information System (LIS), and unique IT and workflow circumstance.
"It was apparent that Health Prime's attention to detail, willingness to delight its customer and collaborative culture fit HPA's vision and values."
- Bruce R. Kline, Practice Administrator
MAKING THE SOLUTION REAL
As soon as Health Prime was selected, a holistic implementation process kicked off.
- Daily and weekly meetings consisting of workflow development and a practice needs assessments built organizational and provider relationships, allowing for collaborative problem solving across disciplines and organizational levels.
- In-person meetings reviewed pathologists’ and laboratory processes along with the needs of HPA coders and office staff.
- Discussion of the coding workflow led to several workflow improvements including the adoption of a computer assisted coding module by HPA.
- A dedicated team concentrated on building electronic interfaces for the transfer of reports and demographics. This established real-time visibility to the revenue cycle with electronic coding and accession level traceability.
- Customized interfaces and workflows were set up for each HPA referring location to accommodate disparate IT systems and reporting formats.
- Discussions about Health Prime reporting capabilities throughout the first months after going live helped HPA customize its reports and maintain visibility to critical metrics, thereby enabling work follow optimization and revenue cycle stability.
- Daily reports were created showing charges, payments, actual collections, and percentage of budgeted goal.
- A full accounting of each month’s financial activity included income projections, payer run rates and adjudication, aging and procedural analysis, reconciliation of the payments posted to the Health Prime billing system, and electronic deposits to the HPA bank account.
VENDOR SELECTION PROCESS
HPA improved financial performance by optimizing revenue cycle processes and increasing efficiency leading to:
Fewer claim errors, denials and rejections
Reduced missed charges and revenue loss
Lower days in AR
A steady, predictable revenue cycle
READY TO OPTIMIZE YOUR PRACTICE’S FINANCIAL HEALTH?
Visit hpiinc.com/pathology today to learn how we can help you streamline operations, boost revenue and enhance efficiency.
Health Prime is a leading revenue cycle management provider trusted for its unique blend of expertise, dedicated client service, proprietary technology and fully employed, scalable delivery model. We ensure precise coding and billing, optimize workflows and drive faster reimbursements and higher collections—helping thousands of physicians nationwide maximize revenue with efficiency.
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