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Large-sized multi-specialty hospital reduced unbilled accounts from $14M to $2M

100K

Registered Users

193M+

Lives Supported

864B+

Billed Claim Value Processed (Annually)

5/5

Top US healthcare payers

4K+

Registered RCM Companies

400+

Plans Served

15.7 M

Charts Coded (Annually)

$4B+

Under Payment Identified

50K+

Medical Lockboxes

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Hitesh Shrawgi

Overview

The client, a large multi-specialty hospital based in Texas, sought HIM document management and remote coding outsourcing solutions. PCH Health provided coding support seven days a week and delivered an end-to-end solution to manage all inbound documents, from medical records and correspondence to invoices. The hospital administration engaged PCH Health to fully outsource HIM document management and coding to achieve cost rationalization and operational efficiencies.

Challenges

  • Inefficient document management process
  • Difficulty in hiring & retaining qualified coders
  • Maintaining acceptable levels of unbilled accounts

PCH Health Solution

  • Initiated the engagement with onsite coding at the main hospital.
  • Provided a complete staff of qualified, credentialed coders to meet the hospital’s coding needs.
  • Established workflows to route documents to the appropriate department, including our AAPC/AHIMA-certified coders.
  • Conducted operational assessments, including work volume reviews, policy and procedure evaluations, process evaluations, monitoring production standards, and developing staffing plans.
  • Reutilized the coding area in new facilities.
  • Transitioned onsite staff to a remote coding center.

Results & Benefits

  • Reduced unbilled accounts from around $14M to $2-3M per week
  • Turnaround time decreased to 48 hours
  • Reduced HIM costs, including training, IT, and headcount
  • Eliminated travel time and expenses
  • Significant improvement in coding quality