The maturity of an organization determines its scalability and operational agility to adjust to shifting reimbursement structures, specifically alternative payment models.
At a 300-bed hospital in Eastern Washington, patient volumes for commercial and federal payers have consistently decreased due to the competitive landscape within the region, a talent deficiency, payer exclusivity clauses, and legacy staff using aged methodologies in a "new age" environment.
Executive predecessors had entered into low-SLA, high-risk contracts with vendor partners, which put the hospital in a problematic situation when cash on hand dropped to under 10 days’ operating revenue, with no quality guarantees to close the revenue gap with the existing partners. The new executive leadership looked to leverage the offshore model to clear the backlogs, meet SLAs, establish a business rhythm, and move the organization to a steady state.
The new organization leadership looked to Vee Healthtek’s India talent pool to close the resource and knowledge gap.
Vee Healthtek is a standout top performer among a robust BPO vendor pool in India. India remains the largest source of talent for exported skills, closely followed by China, Malaysia, the Philippines, and Korea. The Vee Healthtek hybrid India-USA solution offers the broadest range of capabilities to address a multitude of midrange to large-scalable offshore solutions.
Major issues with the existing domestic coding partner required immediate termination of the current contract and transition to another partner.
The hospital’s request for assessment and contract arrived at Vee Healthtek with the caveat that coding operations be active within one week of contract execution. The time from receipt of the fully executed agreement to the launch of the coding implementation process was a mere 24 hours.
The hospital and Vee Healthtek allocated a steering committee to focus exclusively on revenue recognition. Implementation was directed by Vee Healthtek’s US Operations division, in tandem with Vee Healthtek India and functional leaders from various departments at the hospital. Representatives from the Vee Healthtek India Coding Operations team came onsite to the client location and assisted the hospital with encounter workflow mapping to ensure no patient visits were lost in the transition process.
Results:
Within five business days, the Vee Healthtek coding operations team was live in active production with no loss of charge capture. Because the experience and talent level at Vee Healthtek exceeded that of the internal hospital employees, coding leadership was brought in by Vee Healthtek to assist in the training and QA of the internal coding department.
In the first 30 days, the Vee Healthtek India coding team had achieved a 96% coding accuracy score and brought all backlogged queues to within 72 hours from DOS. This quick success prompted the HIM division to outsource all hospital and professional coding to Vee Healthtek. Over the next 11 months, the revenue return from the HIM department’s quality output yielded significantly high revenue, replenishing the organization’s cash on hand from (at its lowest point) three days’ operating revenue to 22 days’ operating revenue.
