How A California-based Multi-speciality Hospital Transformed Its Rcm By 30% With 24/7 Medical Billing Services Support

By Author: Charlie Robinson
Total Articles: 66
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A renowned multi-specialty hospital in California—serving cardiology, orthopedics, oncology, neurology, and internal medicine—faced major roadblocks in managing its revenue cycle. Despite having an in-house billing and coding team, they struggled with the complexities of multi-specialty billing, evolving payer rules, and rising administrative pressure. These challenges led to delayed payments, frequent denials, and lack of clarity in departmental performance, impacting financial stability.
To address these hurdles, the hospital partnered with 24/7 Medical Billing Services, known for its specialty-aware, tech-driven Professional RCM services. Within just one year, the hospital achieved a 30% improvement in revenue performance, highlighting the value of expert external support.
Background: The Need for Comprehensive RCM Support
Previously, the hospital’s billing process was fragmented. Each department handled RCM functions independently, leading to miscommunication, delays, and errors. With limited tools and overwhelmed internal teams, the hospital saw:
• Slower reimbursements
• Inconsistent ...
... coding and documentation
• Revenue leakage from cross-specialty cases
• Poor financial visibility across departments
Leaders realized the urgent need for a centralized, technology-enabled RCM system.
Challenges Faced
Front-End (Patient Access) Issues
Patients receiving care from multiple specialties often had inconsistent records. Insurance verification wasn’t always done in real-time, and co-pays were sometimes missed—leading to claim denials and confusion.
Mid-Cycle Gaps (Documentation & Coding)
Departments documented procedures differently, causing incomplete records. Manual charge entry often missed cross-specialty services, resulting in undercoding and revenue loss.
Back-End (Claims & Collections) Problems
Claims with multiple specialties frequently got rejected due to mismatched documentation. Internal teams lacked resources for proper follow-ups, resulting in prolonged A/R and cash flow issues.
Solution: Partnering with 24/7 Medical Billing Services
24/7 Medical Billing Services began with a full audit and customized a “Patient-to-Payment” strategy suited for multi-specialty workflows. Key improvements included:
Improved Patient Access Workflow
24/7 Medical Billing Services optimized front-end workflows to capture accurate patient data and verify insurance eligibility in real time.
• Centralized registration with standardized data entry
• Real-time eligibility and benefits checks
• Pre-authorization for specialty procedures
• POS collections for co-pays and deductibles
• Clear communication of patient financial responsibilities
These improvements reduced front-end errors and cut eligibility-related claim denials.
Specialty-Focused Clinical Documentation and Coding
Each specialty has unique coding needs. 24/7 Medical Billing Services provided customized training to help physicians meet payer documentation standards.
• Templates designed for each specialty to promote comprehensive documentation
• On-site and virtual training for specialty providers
• Routine coding audits to ensure alignment with current ICD-10, CPT, and HCPCS codes standards
• Correct use of modifiers and bundled codes for complex, multi-specialty cases
These efforts improved claim accuracy and reduced undercoding.
Automated, Accurate Charge Capture
The charge capture process was optimized to efficiently support multi-specialty procedures.
• Seamless EHR-integrated charge entry to ensure real-time service capture
• Automation alerts to prevent duplicate charges or omissions
• Customized charge sheets by specialty to maintain consistency
This automation helped maximize revenue by reducing revenue leakage caused by manual entry errors.
Focused Denial Management and Accounts Receivable Follow-Up
24/7 Medical Billing Services established a dedicated team to monitor denial trends and manage high-value claims across various specialties.
• Denials were categorized and tracked according to specialty
• Appeals were crafted using documentation specific to each department
• Aging A/R was reduced through smart automation and claim prioritization
These strategies accelerated payment cycles and recovered payments that had previously been written off.

Implementation: Seamless and Secure Transition
24/7 Medical Billing Services collaborated closely with hospital teams to onboard each department smoothly. Staff received workflow training, and HIPAA-compliant tools ensured data security. Real-time dashboards enabled performance tracking across specialties—ensuring operational continuity.
Results: Financial Uplift in 12 Months
• 30% revenue improvement
• 37% fewer denials, especially in multi-specialty cases
• 95% clean claim rate
• Faster reimbursements and reduced A/R
• Improved reporting and staff productivity
Conclusion: Centralized RCM for Long-Term Success
This case illustrates how strategic outsourcing can streamline complex multi-specialty billing. With 24/7 Medical Billing Services, the hospital built a stable, compliant, and transparent revenue cycle. Their tailored “Patient-to-Payment” model empowered the hospital to focus on patient care while maintaining strong financial health.

Content Source: [https://www.247medicalbillingservices.com/case-study/how-a-california-based-multi-speciality-hospital-transformed-its-rcm-by-30-percent-with-247-medical-billing-services-support]

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