Better high volume insurance resolution
On average, Optimum Outcomes net cash return on insurance resolution significantly exceeds our competitors’ in head-to-head scenarios. Optimum Outcomes recovers 19.4%, or $3.8 million, more cash annually than our competitor at a Midwestern health system with $4.2 billion in gross revenue.
Lower average patient hold time
Optimum Outcomes average patient hold time is nearly 60% less than competitors, thanks to our innovative methodology.
TCS revenue enhancement results
By performing 835 remit analyses, Optimum Outcomes has helped clients identify opportunities for capturing lost reimbursement as well as improve processes to increase cash. Results include:
- An analysis of a 276-bed hospital with $630 million in annual revenue discovered that the average Medicare Outpatient allowable per remit was $405. After a year of working with Optimum Outcomes, the average grew $113, translating into a cash increase of approximately $319,000 per month or more than $3.8 million annually.
- A 328-bed hospital was not receiving proper payment in 43% of its accounts that involved pacemaker insertions. The TCS Technology pinpointed the problemÂ—accounts listed a device code but no insertion code. The hospital was then able to identify and correct all existing accounts as well as eliminate the problem in the future by educating the catheterization lab technicians on proper coding.
- After working with Optimum Outcomes for 12 months, a 115-bed facility increased its cash per Medicare patient by 29%, per Blue Cross patient by 19% and per Medicaid patient by 7%. This resulted in cash increase per admission of 9.2%.