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CASE STUDY
From Oversight to Optimization: How a Nephrology Practice Solved Their Billing Challenges
CLIENT PROFILE
A midwestern nephrology practice less than three years old servicing office, hospital, and dialysis locations.
THE OPPORTUNITY
Despite being a trusted source of kidney disease and hypertension care within the region, this practice was not producing revenue due to major oversights by their original billing company. Office charges denied by insurance were not being addressed or followed up on, and hospital and dialysis charges were not being entered into the practice management system at all, and therefore were not being submitted to insurance. Additionally, issues with the providers’ credentialing were compounding the problem, making it even more difficult for claims to be processed correctly.
Upon ultimately discovering that the billing company had not properly assigned anyone to their account, the practice contacted MMG to help turn things around.
THE SOLUTION
Within one week of being contacted, MMG was onsite meeting with the practice administrator and one of their leading physicians to learn more about the situation and their specific needs. The team created a detailed client profile overview that outlined the key issues they were trying to solve, then worked quickly to translate that information into a Billing and Credentialing Services proposal, including pricing, system connectivity, staffing and a timeline for onboarding.
After finalizing the partnership, MMG assigned a dedicated RCM team to support the practice’s credentialing and billing.
THE OUTCOME
Since becoming the practice’s partner, MMG has successfully addressed the credentialing and payer issues that plagued their bottom line. The team works closely with the administrator and providers to streamline their revenue cycle process and holds regular meetings with the client to maintain strong processes and results. The client has been pleased to see that, thanks to denials being addressed in a timely manner, monthly collections are strong and the current Days Sales Outstanding (DSO) is under 30 days.