About
4M Healthcare is an independent laboratory based out of Overland Park, KS specializing in UDT and PCR testing.
The Challenge
Managing billing within the laboratory space can prove to be quite complex and labor intensive due to the volume of claims and endless coding combinations.
In April 2018, 4M realized they had grown to a point where handling their billing in-house was no longer sustainable. The company found a vendor they believed could handle the demand of their workload. Unfortunately, that would turn out not to be the case.
Sherry Langrehr, Operations Director at 4M, quickly discovered that their chosen vendor did not have the laboratory experience initially believed. This lack of experience, coupled with an antiquated EMR system, made for a very inefficient and ineffective claims resolution process.
“We felt like we needed to trust our billing company as the experts and that was not the case. We were constantly going in circles, questioning what was being posted, denial resolution, and overall performance. We found ourselves in a difficult situation.”
In May of 2021, as the percentage of 150 day and older A/R inventory continued to swell, 4M decided to make a change. They turned to an industry-leading, cloud-based billing platform to handle their revenue cycle management moving forward—but what about the aged and neglected claims from their legacy application?
Between the added workload due to COVID and a platform migration, 4M’s leadership decided the team was best served to focus on present and future A/R while outsourcing the legacy work to a specialized claim vendor.
The Solution
Learning from 4M’s previous experience, Sherry knew they needed to find a partner that could be trusted to work the A/R as if it were their own.
“Most billing companies like to work your top accounts while being somewhat indifferent with the rest. If they pay, then great, and if they don’t, then they don’t. 4M does not have that mindset. It was a priority to find a company that would dig in the same way that we would.”
Sherry and her team were thorough in their search, interviewing several referral companies and even some offshore options. Ultimately, HCM felt like a partner they could trust.
“We did not want a repeat of the last scenario! At the end of the day, our gut told us we could trust HCM. As soon as we gave HCM access, they hit the ground running. They dug in and went after everything for us!”
The Results
HCM not only drove results in terms of captured revenue but also provided a first-class experience with seamless integration between the two teams, all while ensuring clear and consistent communication.
“The HCM team was quick to learn our system, and they made sure to explain every step being taken with account resolution. They called, emailed, and made meticulous notes within our system. It was a total 180-degree difference from the previous experience. They were so thorough. If a patient called, we knew exactly where the account was from a status perspective!”
Sherry sums up her experience with HCM entirely:
“When you are talking about a company’s finances, you are somewhat nervous as you are putting your organization in the hands of someone else. That said, HCM exceeded our expectations every month we worked with them. They collected way more than we ever thought possible and they saved us! HCM has that IT factor we were looking for in an A/R company!”
Standout Results
- $1.2 million in cash captured in 12 months
- Effectively billed and engaged patients from the legacy application
- Prevented 4M from having to continue to pay for their old billing application
- Supported a mid-year out-of-network scenario with a major payer
We don’t believe in giving up on A/R. Let us care for your aged accounts as if they were our own. Contact us sales@hcmar.com to start the conversation.
