Within three months of implementing the workflow automation and data analytics solutions, Falck achieved their highest collection months in March and April 2021, up 24% from the previous 10 months.
About Falck US
Headquartered in Orange County, California, Falck US is part of the global Falck organization, a leading international provider of emergency response and healthcare services, with 27,000 highly skilled and trained employees in 30 countries delivering more than 9 million services each.
Present in the United States since 2010, the organization provides advanced life support (ALS) and basic life support (BLS) ambulance services. Falck US is the second largest private provider of emergency medical services (EMS) in the country, operating a total of 1,000 ambulances and employing more than 4,000 EMS professionals.
The Challenge
When I joined Falck, I knew we needed an overhaul of RCM systems. I looked at it from a people, process and tool standpoint.
Emergency service environments are fraught with revenue cycle challenges. It’s the nature of the business: fast-moving crisis situations make it more difficult to obtain needed patient demographic and insurance information, leading to difficulties capturing payment. Like many providers of emergency management services, Falck US was struggling with a high bad debt ratio associated with the inability to capture critical patient information and collect patient responsible balances across nearly 50% of ambulance trips—leading to $74 million in bad debt write-offs annually. In addition, Falck’s revenue cycle management (RCM) processes were filled with inconsistencies across the organization’s multiple business offices in terms of the way staff approached daily workflows. Lack of transparency into the various billing functions exacerbated the challenge to improve productivity, reduce overhead costs and identify opportunities for process improvement.
“Manual, disparate processes resulted in overstaffed departments and meant that we were not using our resources as effectively or efficiently as possible.” With support from the executive suite, Kevin set into motion a transformation initiative to improve revenue capture by streamlining and standardizing RCM workflows. The new strategy required a technology infrastructure that would support daily transparency into what staff were doing to hold team members accountable. It also necessitated that Falck overcome the manual, time-consuming burden of pulling meaningful data out of Falck’s current practice management system. “Foundationally, we needed to understand how effective staff were at working the accounts rather than just touching things for the sake of hitting a productivity number,” Kevin said.
The Solution
As part of the first phase rollout, the organization deployed RCM Workflow Automation and Power Analytics to improve transparency into the organization’s financial and operational health and streamline RCM to support better cash flow. Knowing that a large share of claims do not require immediate follow-up, Kevin’s team uses RCM Workflow Automation to help prioritize their workday around activities that have the most potential to generate revenue. The solution uses algorithms to comb through existing claims and assign staff tasks that will improve productivity. It also provides Kevin with consistent visibility across the organization to monitor where productivity and effectiveness may be lagging.
The next-phase deployment will entail implementation of MedEvolve’s financial clearance solution to equip billing staff with the real-time information—demographic, insurance and benefit information—needed to promote more complete capture of patient responsible balances. In addition, Falck recently signed up for MedEvolve’s early-out self-pay and call center offerings from an outsourcing perspective along with insurance discovery, which uses advanced mobile communication technology to get correct insurance information and facilitate the payment.
“We feel that there is a gold mine opportunity there to engage better processes for a healthier bottom-line,” Kevin said.
Given that a significant amount of financial opportunity resides in self-pay or bad debt, the business case for third-party support is an easy one to make.
Outcomes
With MedEvolve Effective Intelligence fully implemented, Falck is benefitting from smarter processes. Instead of billing staff automatically working every claim on a daily basis, the solution directs workflows around claims that have the greatest potential to improve cash flow in the shortest time possible. Falck financial executives have also gained real-time transparency into the financial health of the organization on many levels, providing clarity into claim lifecycle, notable trends or patterns, monthly comparisons and benchmarks. Furthermore, being able to see data at a corporate level in real time across all markets has been a game changer for identifying and implementing changes across the revenue cycle. Within three months of implementing the workflow automation and data analytics solutions, Falck achieved their highest collection months in March and April 2021, up 24% from the previous 10 months.
In an eight-month period following go-live, Falck realized an increase of 14% in insurance payments, and implementation of a mobile engagement strategy yielded a 23.4% increase in collections of patient responsible balances. In addition, mobile engagement with patients has expanded the organization’s ability to identify insurance, which would have otherwise aged to bad debt. Kevin also believes the solution will lay the groundwork for organically decreasing staffing needs by 25%.
Kevin recalled that staff approached the new solution with “cautious enthusiasm”—a perspective that later morphed into resounding approval. “The team agrees that MedEvolve has revolutionized our revenue cycle processes,” Kevin said. He continues, “Besides seeing how many accounts the teams are touching, we have transparency into the effectiveness of those efforts. At the end of the day, you know the effectiveness of a revenue cycle engine by what you bring in the door and how much it’s costing you to do it.”
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