A Large IDD and Community Services Provider

$16M Annual revenue, up from $2M

Situation

The provider could not reliably reconcile the services it delivered against the services it had been approved to deliver. Low approval rates meant ongoing revenue leakage, irregular billing disrupted invoicing cycles, and inconsistent county invoicing increased payment denials.
Then the state introduced a new reporting format, and no off-the-shelf solution existed to meet it. Waiting for a vendor product meant months of reimbursement left at risk.

Automated reporting: Regular reconciliation against county-provided data, returned for validation.
Billing rule integration: Custom logic aligned to evolving state Medicaid rules.
Automated service import: Service data and billing moved through secure file transfer and a proprietary claims platform.
Business intelligence: Real-time dashboards for billing, revenue and forecasting.

Key Takeaway:

Building to a new state reporting standard before vendors catch up turns a compliance burden into a revenue advantage.

Wherever your revenue cycle needs to go, we can help.

STEP 1
Connect
Tell us about your organization, your specialty and where revenue is getting stuck.
STEP 2
Diagnose
We run a No-Cost Financial MRI on your revenue cycle and show you exactly what it finds.
STEP 3
Recover
Together we fix the causes, and the revenue you were missing starts arriving.