Situation

Well known and respected physician provider group contacted The Pinnacle for support and solutions relating to aged accounts receivable collection. The physician provider group had terminated their prior collections company and was experiencing problems with their aged accounts receivable data, collection of the aged accounts receivables and claims resubmissions.

Solution

The Pinnacle team reviewed all aged accounts receivable data and discovered the data was in three different lists and formats. In addition, numerous billing discrepancies were found in the different data formats. To resolve these issues, The Pinnacle team prepared a comprehensive and detailed aged accounts receivable computer model and converted all three lists and formats into one list. The model included all patient information, treatment information, billing and claims submission information, payment information and collections data.

Outcome

By converting all data to one format, billing and claim information was cross referenced and errors corrected. Claims were then resubmitted and collection calls made on behalf of the physician provider group. The Pinnacle team was able to collect over $2 million of outstanding aged claims on behalf of the physician provider group.