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ACP improved efficiency with reduced staff scales HCC process

 

Picture this…you’re a leader in value-based care and were selected to participate in the Medicare Shared Savings Program (MSSP). During your first two years in the MSSP, you deploy a six-step manual process for 12 of your 53 locations to ensure appropriate and accurate HCC codes. Managed by three fulltime ACO employees, the process was designed to review all medical records as well as associated claims. But the process wasn’t efficient.

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The results

TOUCH
Increased productivity
Increased productivity

2 HCC coders needed to cover 53 sites, previously 3 coders were needed for 12 sites

TOUCH
Improved accuracy
Improved accuracy

eliminated a manual, retrospective HCC coding review process

TOUCH
Stronger peace of mind
Stronger peace of mind

knowing there's a compliant, automated review process

The results

radar
 

Reduced/Reallocated

 

10+ FTEs
 
accuracy
 

Reduced Time

 

from date of service to claim submission by two days
optimization
 

Decreased

 

clearinghouse and payer rejections by 3%
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Improved

 

claim resolution rate by 25%
 
 
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The challenge

ACP’s manual process proved to be inefficient, error-prone, and stressful for coders. Coders were constantly rushing to review claims and medical records.



The solution

ACP leveraged Aptarro HCC Coding Engine to automate their pre-claim coding review process.

 

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Proof

Real, satisfied customers

“The automation Aptarro brought to our HCC coding process led to a dramatic productivity hike in our organization and is a key factor in our success with MSSP.”

Director of ACO Operations

The benefits

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The group was able to reduce two full-time positions and reallocate another two full-time positions on their Charge Entry Team. They reduced 11 hours per day of manual charge entry; and automated charge cloning, missing charge reconciliation, and practice transfer. On their AR Team, they were able to reduce four and a half full-time positions and reduce denial tasks by 22%. Finally, on their Coding Team, they were able to reduce two fulltime positions and reduce coding denial tasks by 75%. In all, they were able to reduce or reallocate over ten full-time positions.

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In addition to remedying their staffing challenges, these changes positively increased staff morale and allowed for more professional growth among their existing staff. The simplified processes also eased staffing changeovers and reduced the administrative burden on IT.

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The time from date of service to claim submission was reduced by two days. Their clearinghouse and payer rejections decreased by 3%, backend rejections went from 40% of total rejections down to 15%, and their claim resolution rate three months after implementation was up by 25% of the available opportunity.