“You already know when the Affected person Entry Curator went stay as a result of you may see it in our inventory worth. It helped us drive a $100 million bottom-line enchancment inside two quarters.”
—Ken Kubisty, Vice President of Income Cycle at Precise Sciences
Problem
Precise Sciences is a outstanding most cancers diagnostics laboratory with an annual web income of round $2.6 billion, that’s finest identified for its flagship most cancers screening take a look at, Cologuard. After a interval of fast progress demand for its take a look at, Precise Sciences confronted the tough process of amassing correct affected person information and verifying insurance coverage eligibility at scale. Anticipating a 25% progress in annual testing volumes, Ken Kubisty, Vice President of Income Cycle at Precise Sciences, says the group “wanted an automatic, real-time resolution” to seize correct information from the beginning.
The corporate had 4 particular goals:
- Enhance the accuracy of affected person insurance coverage information to scale back errors and denials.
- Streamline processes to deal with rising testing volumes with out growing headcount.
- Cut back declare denials to herald extra income (particularly these associated to eligibility and well timed submitting).
- Guarantee correct id verification in lab settings, the place affected person, doctor and lab information aren’t unified inside a single information administration system.
Resolution
In want of a single resolution to resolve a number of challenges, Precise Sciences turned to Experian Well being’s Affected person Entry Curator. This new product offered the workforce with a solution to run inquiries for eligibility, Medicare beneficiary identifiers, coordination of advantages, insurance coverage discovery and demographic information with a single click on. As a substitute of juggling a number of merchandise and distributors, registrars would have the ability to seize and confirm affected person information in a single transaction.
By means of automation and machine studying, Affected person Entry Curator may ship ends in lower than 30 seconds and assist submit clear claims the primary time – decreasing the danger of denials whilst volumes elevated. Experian Well being’s implementation specialists configured the software to Precise Sciences’ wants, integrating over 4,000 payer plans nationwide and customizing parameters for real-time eligibility checks and information validation. Experian Well being additionally delivered employees coaching to assist the transition to the brand new system.
Final result
Due to Affected person Entry Curator, Precise Sciences achieved the next outcomes:
- 15% enhance in income per take a look at on account of correct eligibility and fewer denials
- 4x enterprise quantity with out growing headcount
- 50% discount in denials and main enchancment in well timed filings
- $100 million added to the underside line in 6 months
Ken Kubisty, VP of Income Cycle at Precise Sciences, shares how Affected person Entry Curator improved eligibility processes, decreased errors and extra.
General, Kubisty credit Experian Well being’s Affected person Entry Curator for serving to Precise Sciences overcome essential ache factors ensuing from information errors and eligibility points. Fixing for unhealthy information high quality with real-time information correction freed employees from tedious handbook work, making certain sooner, extra correct claims processing – all with out rising headcount. After implementing Affected person Entry Curator, the corporate is able to scale and deal with rising volumes effectively, say goodbye to late submitting denials and scale smarter. For Kubisty, this highlights how know-how drives effectivity and sustainable progress.
Be taught extra about how Affected person Entry Curator helps affected person entry groups stop declare denials by fixing for unhealthy information high quality with real-time information correction.
