The Challenge
A busy urgent care center faced significant RCM challenges:
- Frequent coding inaccuracies due to high patient turnover and diverse visit types
- Increased claim denials from inconsistent documentation
- Delayed reimbursements, with A/R cycles averaging 50+ days
- Front-desk staff overburdened with eligibility checks and patient billing queries
Our Approach
Aivra Health partnered with the urgent care team to streamline their revenue cycle:
- Real-Time Eligibility Verification: Automated insurance checks to avoid front-end errors.
- Specialty-Specific Coding Support: Accurate coding tailored for urgent care’s high-volume, fast-paced environment.
- Denial Prevention & Management: Identified patterns in payer denials and applied corrective strategies.
- Patient-Friendly Billing: Simplified billing statements and improved communication for transparency.
The Results
- Denial rate reduced by 55% in the first quarter
- A/R cycle shortened from 52 days to 30 days
- $220,000 in lost revenue recovered through denial appeals and improved follow-up
- Improved patient satisfaction scores due to clearer billing processes
- Staff efficiency increased as front-desk workload dropped by 20%
