Within One Year, Michiana Hematology Oncology (MHO) Reports Identifiable Recoverable Revenue of $2.8 Million in Total Underpayments and $333,000 in Missed Drug Billings
South Bend, IN – AC3’s oncology intelligence platform, uniting all oncology practice management data into a single environment, proves it can deliver promised results in actual practice. Within one year, oncology powerhouse Michiana Hematology Oncology (MHO) reports $1.66M in additional revenue to the bottom line due to improved net collections rate, in addition to underpayment revenue recovery of $2.8 million for patient treatments and $333,000 in missed drug billings.
Across the medical industry, the inability to efficiently and accurately update and integrate contractual fee schedule rates from insurance companies into medical billing systems robs medical practices of profit – this is especially acute in oncology, because of the complex treatment protocols and insurance fee schedules that are frequently unique to oncology practices.
Rising costs, declining reimbursements, and increasing operational complexity have resulted in more independent oncology and other specialty practices being absorbed into health systems. Lack of transparency into the true financial health of a practice is a large part of this.
The oncology intelligence platform developed by AC3 brings together data previously held in multiple systems, or not captured at all. The oncology intelligence platform integrates fee schedule intelligence, claims intelligence, practice performance intelligence, and pharma intelligence solutions into one system.
With the data united, AC3’s intelligent automated business rules logic and auditing capabilities can process and simplify billions of data points a day, including diving deep down to the individual transaction level of every claim to validate them against the contractual fee schedule allowances and uncover invisible revenue opportunities.
This transaction level data transparency has resulted in significant revenue recovery and operational improvement gains.
By gaining visibility into MHO’s multi-sites future patient appointments and treatment needs, they were able to allocate inventory between multiple sites daily to optimize utilization and minimize high inventory levels, resulting in a 60% increase of cash on hand due to reduction in pharmaceutical inventory required.
Prior to AC3’s platform, oncology practices were often forced to resort to manual auditing and spreadsheet management. While an audit might be able to identify large discrepancies it was much more difficult to find the multiple thousands of smaller discrepancies that eat away at practice revenue.
MHO Chief Executive Officer, Susan Ford, shared her insights on using AC3’s oncology intelligence platform, stating, “Without AC3, it would take us months to do what they could get to us in a moment. AC3 has simplified many back-office billing and operational processes in addition to accelerating access to meaningful data insights. It’s the right data insight at the right moment to allow MHO to perform its best.”
The ability to understand all cost data has a larger purpose outside of the revenue growth. While working with AC3 has allowed MHO to preserve revenue integrity, it has also granted the opportunity to further explore applying advanced analytics within other avenues of their business.
MHO is the largest team of board-certified oncologists in Northern Indiana. The physician-owned practice has 21 providers, including 12 medical oncologists, four radiation oncologists, and five advanced practice nurses. MHO provides integrated and comprehensive medical and radiation oncology services under one roof, including nutritional consults, chemotherapy, radiation therapy, and 24-hour oncology-certified nursing assistance. For more information.
AC3 unites clinical, operational, and administrative oncology expertise with healthcare data and technology expertise to deliver actionable insights that will transform the entire healthcare delivery system into one that empowers stakeholders to focus on quality, cost, and patient access. For more information.