Large Revenue Cycle Provider expands capabilities and expertise rapidly with the help of Titan Health’s team.

The Challenge

A national revenue cycle management (RCM) company needed to resolve a high volume of complex aged accounts for 3 large healthcare systems with over 100 hospital locations on 33 different patient accounting systems. Accounts were aged over 365 days, and included denials, partial payments, COB, authorization, billing errors and missing charges, and required expert account audit to determine paths to resolution. The accounts varied across nearly 500 payors and over 10 states, and required high levels of cross-functional expertise to ensure that maximum revenue was recovered.

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These accounts needed to be resolved rapidly to attain compliance with contractual and financial requirements.

The Solution

Titan Health provided the expert solution to audit, appeal, and collect/resolve these time-sensitive high volume accounts. Titan Health trained their team and seamlessly became an extension of the RCM Provider’s solution within three weeks. Nearly every accounts required detailed audit, appeal, rebill, and/or coding changes to enable successful recovery.

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The Titan Health team developed and implemented a customized workflow process tailored to the unique challenge. This included customized reporting and a detailed quality assurance process designed to ensure both productivity and correct action on all accounts. This allowed Titan to provide assurance to the RCM provider and their hospital systems that their claims were being worked timely and with a high level of quality. This was all enabled by Titan’s proprietary technology platform, METIS™.

The Results

Titan worked and resolved more than 26,000 accounts across hundreds of payors, resulting in over $25 million in recoveries over a period of 6 months. Titan also provided insight into recurring trends and root cause analysis to assist in preventing future errors and payment delays. This enabled the RCM company to meet its contractual and financial obligations within a short period of time.