simplified processes, stronger revenue, sustainable growth
Premier Inpatient Partners | Southwest Florida
  • Female Dr and male nurse

    30-plus physician hospitalist and acute care practice

  • hospital and trees

    14 sites

Challenges

  • Claim write-offs of 5% to 10%
  • Low reimbursement rate
  • No visibility into performance metrics
  • Unable to address provider reimbursement fluctuations

Solutions

  • athenaOne
  • athenaCollector
  • CaduceusHealth

Results

  • 10% to 15% revenue increase
  • Grew from 12 to 30-plus physicians
  • Reduced administrative workload
  • Decreased days in accounts receivable (DAR)
  • Eliminated uncollectable and aged-out claims
  • Clean claims rate of over 90%

Dr. Jonathan Marsh is Managing Partner at Premier Inpatient Partners (PIP), a privately held, hospitalist and post-acute care company in Collier County, Florida. As a company founder and full-time physician, Marsh oversees billing and reimbursement for PIP’s work at five local hospitals and a growing number of skilled nursing and rehabilitation facilities.

At the company’s inception in 2016, claims processing was outsourced to a billing provider that struggled with the volume and didn’t collect an estimated to 10 percent of claims each month. A lack of reporting on performance metrics and claim status contributed to lost revenue. Marsh decided to move the company’s billing to athenaCollector and CaduceusHealth, a complementary solution providing revenue cycle management services and technology with robust collections capabilities and data transparency.

“The implementation was the smoothest of all billing company switchovers that I’ve participated in,” said Marsh. “When the integrated solution went live, it immediately sped up claims processing and reduced collection time.”

The solution also freed Marsh to spend more of his time working as a physician treating hospital patients — the role he enjoys most. “I immediately gained back the 30 percent of my time spent fixing billing problems,” Marsh added.

Faster claims processing boosts financial performance

Implementing the integrated billing solution of athenaCollector and CaduceusHealth led to quicker turnaround on collections than Marsh and his team were used to. “Caduceus and athena capture 100 percent of the claims our team generates at multiple locations,” he said. “That directly resulted in a 10 to 15 percent growth in revenue.”

Eliminating prior revenue leakage points enabled PIP to realize its total revenue for the first time. This helped fuel the hospitalists’ growth from 12 to more than 30 physicians.

Analytics pinpoint underperforming areas and catch problems before processing claims

Detailed reporting from athenahealth and CaduceusHealth enabled Marsh to track collections more effectively, including analyzing reimbursement rates by payer. The increased visibility helped Marsh and his partners focus the company on higher-profit health networks and reimbursement plans, while keeping up with trends in physician coding.

“I can look at any combination of data from athena and Caduceus and know the numbers are accurate,” said Marsh. “For example, if I want to see percent of collections at one location, from month to month, I can see that data immediately in a chart that’s understandable.”

In the future, Marsh sees athenaCollector and CaduceusHealth playing a key role in Premier Inpatient Partners’ expansion into additional hospitals, and with the addition of athenaOne, into post-acute facilities as well. “athenaOne supports everyone from small group practices to large physician networks,” said Marsh. “Knowing that our billing and our clinical services are scalable will facilitate our growth while minimizing administrative burden.”

 

We used to worry about claims and collections. With athena and Caduceus, we know every last dollar is taken care of.

- Dr. Jonathan Marsh, Founder and Managing Partner

* These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.