Challenge
A large, multi-state healthcare system operating several dozen hospitals experienced a common frustration — managing the complex, arcane processes required for Veterans Affairs (VA) and other military insurance. While qualified revenue cycle staff are in short supply across the board, those with VA expertise are especially hard to find. Like so many others dealing with administrative burdens and resource constraints, the health system struggled to fully optimize VA claims and military insurance reimbursement and needed to find a better way.
Solution
In their search for a strong revenue cycle partner, the health system selected R1 Complex Claims, part of R1 Acceleration Suite, to help them improve VA claims management and increase revenue. R1’s team of complex claims experts not only provided end-to-end services from eligibility and authorization verification to overturning denials, but they also worked directly within the health system’s Epic environment and quickly became a trusted extension of the revenue cycle team. After implementing R1 Complex Claims at a number of hospitals within the health system’s Central Business Office (CBO), VA revenue took an immediate upward turn.
Results
Within five months of go-live, the health system’s monthly VA revenue jumped by 75% over their baseline average. The health system was so pleased with the initial results that they quickly added more hospitals from their CBO to the program and are exploring other complex claims that R1’s experts can support. With those additional facilities online, monthly VA and military revenues have reached $3.2 million, effectively doubling the health system’s monthly VA/military revenue stream.
