Founded in 1981, Primary Health Care (PHC) is a community health center (CHC) providing medical and dental care to undeserved individuals and families in Iowa. PHC hosts seven medical clinics, three dental clinics and four satellite clinics across three communities. In 2016, their clinics and programs served 36,898 patients and clients with approximately 146,000 encounters.
PHC was frustrated with their inability to get access to critical information buried within their billing system. Most importantly, they couldn’t understand why their denial rate was so high — or what they could do about it. The lack of actionable data meant they had no choice but to try to address problems through trial and error rather than data-driven decision making.
PHC began leveraging RevenueHealth’s data solutions in March 2018. They began to see significant results within the first 90 days, eventually reporting an 11.4% drop in their denial rate over the first nine months compared with the previous nine months. During the same period, their blended encounter rate — a key statistic for measuring revenue cycle management health — rose by 11.5%. By the end of 2018, their re-denial rate stood at just 2.15%.
“RevenueHealth has taken our data, made it into something that could be manipulated, sorted and reported on, and given it back to us in the form of summaries that explain why our claims are being denied. It all goes back to our overall goal for our revenue cycle function: Get a clean claim to the paying entity approved the first time we submit it.”
Martin Watt, CPA
Chief Financial Officer
Primary Health Care