GetixHealth, a leading provider of revenue cycle management (RCM) services to the healthcare industry, is dedicated to helping its clients increase profitability through a more efficient, robust revenue cycle. Operating as an extension of its clients’ organizations, GetixHealth offers everything from management consulting and patient billing to self-pay options and insurance follow-up.
Over the past four years, GetixHealth has expanded its reach and capabilities through 11 acquisitions. Its workforce is now 1,700 employees strong across the U.S., China, and India; roughly 250 of these employees make outbound calls to insurers to follow up on claims. These collectors are spread out in various locations, and many work remotely from home.
As GetixHealth has grown, so have its challenges. The formula for maximizing clients’ ROI has never been more complex. In response, the company has taken a much harder look at its operations, hoping to simplify them in ways that deliver more value.
Like many healthcare providers and RCM service providers, GetixHealth was struggling with big hindrances on the back end of the revenue cycle. Among the biggest was a lack of visibility into what collectors were doing during and between phone calls with payers.
Team leaders were relying solely on individual collectors’ accounts of their own activity—i.e., accounts worked and claim denials in the course of a shift. Based only on these self-reported numbers, collectors appeared to be working an average of five accounts per hour.
Without real-time performance data, however, team leaders had no way to verify (let alone improve) these numbers—thus making it tough for GetixHealth to demonstrate the true value of its insurance follow-up services or drive continual progress on the front line.
GetixHealth was also burdened by an all-too-familiar, seemingly intractable problem: long hold times for payer calls. Fortunately, the company would soon discover an easy workaround—and with it, a whole new level of efficiency.
An Artiva HCx® customer since 2010, GetixHealth was recently introduced to the Artiva Magnify™ solution, an EHR complement designed to help manage and improve collector productivity. GetixHealth chose to implement a pilot program at one of its call centers ahead of an on-site visit by one of its clients, an internationally renowned medical facility.
Insurance Hold Manager (IHM) – This feature can reduce hold times for payer calls by up to 80%. As collectors talk to payers to resolve claims, IHM works in the background, automatically navigating payers’ interactive voice response (IVR) and consuming/managing payer hold time. IHM proactively stages the next wave of payer calls, connecting each automated call to a collector moments before the payer picks up. Average call times are captured and used to launch additional calls so collectors can connect with payers in quick succession.
“Insurance Hold Manager, and Artiva Magnify as a whole, are going to introduce a culture change in the biller and insurance follow-up world. Connect quickly, use your Look Ahead, and maximize every payer call. You can turn this into a very, very efficient process.”
Kimberlee Smallwood
Site director, A/R follow-up
GetixHealth
Look Ahead – By delivering the next set of priority claims to collectors’ desktop screens in real time, this feature ensures collectors maximize their talk time with payers and comply with employer policy to work as many claims per call as payers will allow. With Look Ahead, collectors can easily work 3-5 claims per call as soon as they connect.
Automated Quality Assurance (QA) – Automated QA allows for a more robust, valuable performance management program that’s far less time consuming than manual QA. Team managers don’t need to search for accounts or call recordings; all QA data are housed together in one system.
On day one, Artiva Magnify’s IHM and Look Ahead features delivered an immediate boost to the GetixHealth collection team. As client representatives shadowed a collector on the floor, they were amazed to watch that collector move quickly from one connection to the next, handling five separate account statuses on a single call.
While GetixHealth’s average number of accounts worked per hour has increased from five to eight, the company has also transformed performance management through its ability to track collector activity in real-time. “We now have a better ability to monitor our work-at-home users,” says GetixHealth CTO David Stuart. “We can monitor in real-time whether they’re on hold, connected to a call, or doing something else.”
“We saw huge efficiency gains in the first hour of implementing this pilot,” says Kimberlee Smallwood, site director for A/R follow-up. “We’ve since seen our newest collectors hit the ground running with IHM, even surpassing some of our more seasoned employees. On every important measure, we continue to see results that amaze us.”
Insurance Hold Manager™
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Supercharging A/R Productivity: How to Reduce Payer Hold Times and Manage Remote Agents with Ease |
Unleash Agent Performance |
| Register to attend or receive a free replay of this webinar. | Here’s how Insurance Hold Manager helps agents maximize call volumes along with opportunities to work high-priority claims. | |
