Healthcare co. needs healthier reimbursement process

Picture this...

You’re a healthcare services company that operates long-term, acute-care hospitals and provides rehabilitation services across the U.S. You’ve hired a third-party collections agency to collect Account Receivables, but you don’t have clear visibility into agency billing vs. collections accounts and want to understand potential over/under billing. In other words, you need to make sure the money you’ve collected matches what you’re getting—and you need help finding out.

You turn to Accordion.

We partner with your team to reconcile third-party and internal collections data to identify the variances in billings by the collections agency. We find that only 14% of the total claimed amount has a unique identifier that maps the third-party data with internal collections data—and we need to map the other 86%. We: ​

• Create a unique identifier using different combinations of data fields (e.g., bill # assigned using file number, assigned using payment date and amount, etc.) to map the transactions amounting to the remaining 86% of the total claimed amount.​
• Identify a list of overbilled transactions/bills at each facility that you’re able to claim for reimbursement. ​
• Create Excel & Power BI dashboards to facilitate reconciliation at multiple levels (district/facility/patient/transaction) that can be refreshed on a monthly basis.

Your value is enhanced.

You successfully reconcile the third-party collections data with your internal collections data to identify 5% of the total claimed amount as net overbillings for transactions over a period of 18 months. This leads to a potential reimbursement of 8% of the total fee from third-party collections agency.