Healthcare Provider Case Studies

High Aged And Complex AR

The Client: A leading, multi-specialty medical group and health system, this customer has multiple outpatient specialties with 300+ physicians. Approximately $600M+ in charges and $170M+ in collections annually.

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Coding Auditing RAC - Health System

Client Details: Our client is a major health system with multiple hospitals. Vee Technologies provides various services including Coding, Auditing, and RAC (Recovery Audit Contractor) review process for this client. The Recovery audit program is an audit program to identify improper Medicare payments including overpayments and underpayments as a result of coding issues. All the hospitals in this health system send the audit recommendations they receive from RAC to Vee Technologies coders to validate the audit findings.

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Revenue Optimization & Staff Augmentation for a major health system

Challenges: Our client, a major university health system, was looking to optimize revenue. They had millions of dollars on hold as the claims hit the clearing house due to improper coding, POS and modifier issues, demographic mismatch etc. Providers may have given illegible medical reports which prevented the coders to code with highest specificity. Unavailability of experienced staff created a backlog which caused revenue leakage. Clearing the denials within the TFL was another challenge due to the shortage of expert coders.

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