COHA (Oncology)

Fedora Solutions offers comprehensive revenue cycle management services to healthcare practices, such as Chesapeake Oncology & Hematology. We specialize in assisting healthcare providers with streamlining billing processes, reducing claim denials, and optimizing financial performance.

Streamline Revenue Cycle: Client’s primary goal was to improve the overall efficiency of the clinic’s revenue cycle process and better cash flow.

PMS/Software Transition: Careful planning, coordination, and implementation to ensure a smooth transition without disrupting daily operations and patient care.

Optimize Financial Performance: The clinic aimed to enhance collections and achieve quicker reimbursements for improved financial health.

Comprehensive Analysis: Fedora thoroughly reviewed the clinic’s revenue cycle processes, identified the process gaps, and analyzed reimbursement rates and fee schedules to optimize revenue.

Client-Centric Approach: Clear and transparent communication, tailoring the processes based on client requirements, proactive drug reimbursement analysis to avoid revenue loss, streamlined claims submission, and claim query management to avoid late submission.

Issues contributing to revenue cycle inefficiencies were identified, such as inaccurate demographics and benefit verification, lack of adherence to billing guidelines, errors in the billing process due to communication gap between old billing department and physicians, interface issues between EMR and PMS causing data entry errors in LAB charges, delayed & inadequate follow-up on unpaid claims resulting in high accounts receivables, delayed patient registration process affecting timely billing and submission, lack of supervision in accounts receivables, and lack of implementing new changes and compliance requirements.

Proposed streamlining workflows: Ensure accurate and complete demographic registration and insurance information, streamline workflow for prior authorization process, streamline workflow for query management between physician and billing team, establish clear guidelines and workflows for managing denied claims and unpaid claims, and conduct monthly/quarterly review & comparison of payments with payer fee schedule.

Collaborative Process: The practice, Chesapeake Oncology, experienced a smooth onboarding process with personalized support from the Fedora team.

Effective Training & Transition: The PMS/software transition was executed smoothly and efficiently, ensuring minimal disruption to operations and patient care.

Customized Solutions: Fedora tailored the implementation to the specific needs of the clinic, such as moving old PMS data to new PMS, ensuring a successful transition.

Decreased Errors: Client noticed a significant reduction in claim denials after the implementation of Fedora’s solutions. This positive outcome underscores the effectiveness of accurate benefit verification and timely prior authorization of drugs with accurate billing.

Faster Reimbursements: The clinic experienced faster reimbursements, leading to improved cash flow and financial stability. Also, Fedora assisted in negotiating contracts.

Efficient Collections: Timely claim submission and regular follow-ups on unpaid & denied claims resulted in decreased accounts receivable and improved cash flow.