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Case Study

Outsourcing RCM Yields Operational Efficiency to Support Growth

pccma logo

Pulmonary & Critical Care Medicine Associates is Central Pennsylvania’s largest independent pulmonary practice group and UPMC Pinnacle’s select provider of pulmonary and critical care at UPMC Pinnacle hospitals in Central Pennsylvania.

Established in 1978, PCCMA is made up of 13 clinicians across 3 locations. By providing comprehensive evaluation and care for lung conditions and sleep-related problems, PCCMA is able to provide the highest level of compassionate care for patients to improve their quality of life.

Locations

3


Providers

13


eClinicalWorks Users since

2005

The Challenge

As the team at Pulmonary and Critical Care Medicine Associates (PCCMA) looked to expand, they recognized a need for professional services to help collect the accumulating outstanding revenue. Before partnering with Revele RCM, PCCMA managed the medical billing internally. To scale for growth, PCCMA turned to Revele RCM to improve the accounts receivables and improve overall use of the eClinicalWorks electronic health records software.

Since transitioning to Revele RCM, Pulmonary and Critical Care Medicine Associates has been able to expand their capabilities internally.

PCCMA’s Client Success Team at Revele has provided them with an additional layer of intelligence when it comes to medical coding, the Merit-based Incentive Payment System, revenue cycle management and eClinicalWorks optimization.

In return, PCCMA has been able to improve revenue cycle performance while simultaneously becoming more efficient in other administrative tasks.

 

Revele’s core team is the base of their support and they continue to impress our staff with their ability to address all of our concerns, even those outside the scope of billing.

This includes eCW interface coordination, MIPS rollout, training of our Medical Assistants on EMR workflow and documentation, and data analysis for business development projects.

Jason Alexander, Chief Executive Officer
Jason Alexander, Chief Executive Officer Pulmonary & Critical Care Medicine Associates

The Solution

27% Decrease in AR Greater than 90

  • Medical Coding Review

  • Insurance Eligibility Verification

  • Front desk training on best practices

  • Clearinghouse edits

  • Claim scrubbing

  • Line item payment posting

  • Auto claim submission EDI

  • Allocate payments paper EOBs

  • Out of office charge capture process

  • Electronic work comp claim submission


66% Decrease in Gross AR

  • Patient statement services

  • Insurance follow-up

  • Appeals management

  • Transition to collections

  • Detailed performance reporting


41% Increase in Net Collections

  • Patient call center services

  • Insurance follow-up

  • Proactive and reactive claim follow-up

  • Appeals management

  • Financial reconciliation

  • Detailed performance reporting

 

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