CASE STUDIES

$750M+, Non-profit, Regional Healthcare Organization in the Southern United States

Challenges

Outdated Revenue Cycle Operations (RCO) system builds/processes that did not meet requirements during a rapid organizational growth.  Need for finance to have an accurate and dependable cash flow forecast from RCO.  Staff were lacking current knowledge in ever-changing billing requirements.  Distrust and disconnect between IT and RCO.

Solution

Provided RCO transformation driven by Texican’s Life of Claim and Analytics to establish a reliable, core revenue cycle organization, delivering sustainable results. Conducted continuous triage and assessment of core processes and peripheral RCO technology integration.

Results

The transformation engagement resulted in total cash flow improvement of $146M  . Just as remarkable, our client during COVID-19 was able to grow cash while mitigating significant financial and organizational impacts experienced by other healthcare organizations.  This work helped them to position for a highly successful merger.
$48.6M
9.8%
200%
29%

Increase in Incremental Annual Cash Flow
Year Over Year Cash Flow Growth
Increase in Clean Claim Rate
Improvement in Point of Service Collections



350 Physician’s Group and 40 Points of Service in Central Florida

Challenges

Rapid growth through acquisition resulting in different cultures, Revenue Cycle Operations, leadership, and internal politics.  The different cultures perpetuated a scenario of growing receivables, reduction in cash flow, revenue leakage, inability to meet financial goals and dysfunctional relationship between IT and RCO.

Solution

Conducted a 19-month engagement where we implemented Transaction Based Workflow and conducted charge redesign education and intake training for staff. All while enabling meaningful use compliance and shifting the organization from 60% to 100% compliance of electronic charge capture. While redeploying the  host system, and conducting an EMR upgrade and physician onboarding.

Results

On $210M annual patient revenue, improved cash flow $89.3 million over the course of the engagement, reduced AR days by 9 days, and improved clean claim rate 21% and improved cash to charge by 3.25%.
$89.3M
3.25%
15.4%
21%

Increase in Incremental Cash Flow
Cash to Charge Improvement
Reduced A/R Days
Increase in Clean Claims Rate



900-Bed Integrated Delivery Network in Central Florida

Challenges

Difficulty in achieving Revenu Cycle Operations (RCO) goals set by senior leadership.  Staff lacked training and were overwhelmed with workflow backlogs.  RCO needed new leadership, training, mentorship, and motivation to meet the ever-changing payer rules and requirements.

Solution

Texican provided interim RCO leadership that led with training and mentorship to optimize the poorly performing operation. Staff Training and accountability were structurally put in place resulting in a change of culture. Texican’s Life of a Claim (LOAC) software provided workflow management and analytics to continuously improve operational results.

Results

In the first 15 months the system realized $52M in incremental cash flow and 4.8% improvement in cash to charge improvement and a 15% increase in Point of Service collections as well as reduction in bad debt % of gross revenue of ½ %.
$52M
4.8%
15%
9.9%

Cash Flow Improvement
Cash to Charges Increase
Increase in Point of Service Collections
Decline in Cost to Collect



450-Bed Regional Health System in South Texas

Challenges

Weak revenue cycle leadership, lack of standardized processes for training, documentation, & staff evaluation, and poorly developed outsource arrangements.

Solution

We provided interim medical records, patient access, & business office leadership and replaced outsource company with our automated solutions software and proven operations strategy.

Results

Improved cash flow $21.3 million or 17% over previous yearly average, reduced DNFB by 5.5 days, and reduced bad debt from 4.2% of gross revenue to 3.1%.
$21M
17%
32%
400%

Increase in Incremental Cash Flow
Year Over Year Cash Flow Growth
Reduction in Net Days in Accounts Receivable
Reduction in Total Denials



988-Bed Regional Health System in the South

Challenges

Growing accounts receivables and shrinking monthly cash flow after a patient accounting system conversion and weak revenue cycle leadership.

Solution

We provided interim business office leadership and implemented Texican automated solutions software to replace poorly performing system.

Results

Improved cash flow $29.1 million or 13% over previous yearly average, reduced total accounts receivable by 17%, and reduced service level denials 33%.
$29M
13%
38%
50%

Increase in Incremental Cash Flow
Year Over Year Cash Flow Growth
Reduction in Net Days in Accounts Receivable
Reduction in Medicare Claim Denials



 

800-Bed 5-Hospital System in the Southeast

Challenges

Weak revenue cycle leadership, escalating days in A/R, decreasing monthly cash flow, and poor communication between revenue cycle departments.

Solution

We provided interim patient access and business office leadership and implemented our automated software and operations management systems.

Results

$11.6 million increase in cash flow over baseline in 3 month period after engagement and system has maintained net A/R days in low 50s for past 3 years.
$45M
24%
42%
$3.3 mil

Increase in Cash Flow
Cash Flow Growth
Reduction in Net Days in Accounts Receivable
Avg. Monthly Cash Flow Increase



What Our Clients Say

“Texican helped us achieve great results in the financial turnaround of our business office. Their highly skilled personnel and attention to detail generated significant additional cash flow for our organization”
Florida, Hospital
“With the assistance of Texican’s highly knowledgable staff our team was able to focus on recent receivables while they identified issues afflicting past receivables and solved existing problems. It was very refreshing to receive weekly reports on the project status, knowing it would be on time.”
California, Hospital
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