Eleanor Health is a provider of mental health treatment and substance use and associated behavioral disorder treatment based in Massachusetts that currently operates 32 clinics across seven states.
The Challenge
The Eleanor Health team was battling a constant daily grind of manual billing and coding work. Due to their specialty contracts with payers, they have a unique process in which every service rolls up into a monthly bundled rate. Each month the team sends one claim for all services to each payer—and each payer has different requirements. To ensure each payer was getting the right information, the team spent significant time manually reviewing all services and the payers’ requirements. It took them over 15 days to complete billing and claim submission at the end of the month. To reduce the manual workload, the team needed to find a way to automate their complex processes.
The Solution
The RCxRules team worked with Eleanor Health to create a custom AI solution to address their unique workflow requirements. “The implementation team was incredibly helpful and easy to communicate with. They were able to immediately understand whatever I was trying to explain, there wasn’t a lot of back and forth needed to get results,” explains Elizabeth Strohminger, Revenue Systems Manager at Eleanor Health.
“I would definitely recommend working with RCxRules. The team is so knowledgeable and able to help with custom functionality to address unique issues. I love their honesty—everyone was candid about what the solution can and can’t do. The whole process was very transparent.”
The Results
Prior to implementing RCxRules, the average charge entry lag was nine days. It’s now down to four, and the Eleanor Health team is able to close out their month in one day instead of fifteen. They have also been able to expand their business without hiring additional billing and coding staff.
The effect on employee morale has been significant. “We do employee satisfaction surveys every January and July. Once we implemented RCxRules we saw a 24% increase in employee satisfaction. Our goal is a 75% net promoter score and we’re currently at 83%. We’ve seen employees go from feeling totally overwhelmed to feeling secure and satisfied in their roles. It's a win for us in terms of productivity, and an obvious win for our employees’ wellbeing,” Elizabeth says.
Find out how other large medical groups use RCxRules software to boost efficiency by exploring these success stories.
