Achieving a 98% Collection Rate for Clinical B ABA Therapy

Client Overview

Client Overview

Clinical Behavior specializes in Applied Behavior Analysis therapy and behavioral health services for individuals with developmental disabilities. Their team of Board-Certified Behavior Analysts and mental health professionals is committed to high-quality care, aiming to improve clients' quality of life through evidence-based practices and personalized support.

Goal

Goal

The primary goal was to enhance the client's revenue cycle by increasing their collection rate from an initial 78% to a higher, more sustainable level. This improvement aimed to ensure financial stability, reduce billing errors, and align the client's performance with or above industry standards.

Challenges

Previous Challenges

• Significant difficulty in securing timely payments from a specific payor, leading to prolonged claims processing and frequent denials.
• Inefficient and outdated billing and follow-up procedures that failed to address payment issues effectively.
• Increased labor costs due to higher staff hours dedicated to resolving payment discrepancies and managing claims, which still resulted in suboptimal outcomes.
• Strain on the organization’s budget and diversion of resources from strategic, growth-oriented activities due to reliance on labor-intensive processes.
• Inadequate use of reporting features in their billing system, leading to poor tracking and analysis of revenue cycle data.
• Missed revenue opportunities due to the lack of comprehensive data management and timely intervention.

Solutions

Solutions for Tackling Root Cause

• Enhanced Follow
  Up Protocols - Introduced automated and structured follow-up protocols for claims, reducing delays and improving payment timelines.
• Data-Driven Approach
  Leveraged reporting features within the billing system to track revenue cycle metrics, enabling the identification and correction of missed revenue opportunities.
• Owner Training and Efficiency
  Trained owner on the new processes and reporting tools to reduce manual errors and enhance efficiency.
• Dedicated Payor Management
  Implemented a targeted strategy to manage and resolve specific payor-related issues, including customized follow-up routines and escalations.
• Monitoring and Continuous Improvement
  Established a system for ongoing monitoring and iterative improvements to maintain efficiency and adapt to any new challenges that arose.

Results

Results Achieved

Savings of over $50,000 annually by choosing to go with Theralytics.

Significant Increase in Collection Rate

The collection rate improved from 78% to 98%. Above Industry Average Performance - The new collection rate exceeded the ABA industry average of 95% by 3%, showcasing exceptional performance.

Enhanced Cash Flow

The improvements led to a 22% boost in business cash flow, strengthening financial stability and operational flexibility.

Reduction in Billing Errors

A 16% decrease in billing errors was achieved due to more consistent and efficient processes.

Labor Cost Savings

Reduced reliance on manual labor for claim management, allowing staff to focus on strategic tasks and improving overall productivity.

Improved Financial Predictability

Enhanced tracking and reporting practices provided better visibility into the revenue cycle, facilitating informed decision-making and financial forecasting.

Sustainable Process Improvements

The client established robust billing practices and a proactive follow-up system, contributing to long-term sustainability and continued operational efficiency.