Central Management Needed a SNF Tech Partner – Not Just Another Claims App

About Central Management Company

A 55+ year long-term care expert, this organization is headquartered in Winnfield, Louisiana, and centralizes billing across its 22 skilled nursing facilities.

Executive Summary

Reducing days outstanding is a key strategy for the Revenue Cycle Management group at Central Management.  To be successful they needed more than just a claims app. They needed a tech partner who could understand and respond to the idiosyncrasies of skilled nursing claims. 

Challenges

Although they had a claims app to check eligibility and process Medicare/Medicaid back in 2015, Central Management began looking for a tech partner who would listen and respond to the specific demands of SNF claims processing.

The post-acute marketplace is an ever-changing entity with Medicare, Medicaid, and managed care plans – and each payer has slightly different demands. A nimble claims partner who understands tech AND the industry is a must to keep the revenue flowing. 

"Not every software vendor takes the time to hear the customer and what they need. The primeCLAIMS team is flexible, open to discussion, and let customers help drive product."

– Jeff Cantrell, CFO

How primeCLAIMS Helped

In Central Management's search for a true claims partner in the claims revenue cycle, they found our primeCLAIMS app, designed for billers, by billers – and supported by billers. This customization resulted in their claims getting paid faster, with less time/resources burned.

Along with other clients, Central Management quickly benefited from our secondary claims feature, which is truly automated when compared to others still requiring print/mail/fax. PrimeCLAIMS' one-of-a-kind secondary automation is truly an unsung hero in the game of reducing days outstanding.

In the seven years since our relationship began, Central Management has appreciated our willingness to continue to develop the app with their input in mind. They are a member of our Customer Advisory Board and a willing beta tester who provides feedback on enhancements made to primeCLAIMS.

"We've been very pleased about the quick turnaround of our primeCLAIMS enhancement requests. The team takes time to listen and understand features that really help streamline our processes."

– Casey Womack, Lead Facilities Coordinator

One enhancement they've played a role in is the intuitive dashboard users see when they log into primeCLAIMS. It is literally a clickable to-do list for each day, informing processors of which claims need action to progress toward payment. It alerts of errors, rejected claims, secondary claim candidates, and the status of Medicare claims in process.

"We love the primeCLAIMS home screen. We can jump right into what needs to be done."

– Casey Womack, Lead Facilities Coordinator

Results

Central Management gained these efficiencies via primeCLAIMS:

• Complete coinsurance billing in a quarter of the time it used to take. They often spent days completing related monthly tasks.
• Save a couple of days using EzDDE and the claims in process (CLIP) features. It's easier to determine Medicare corrections before finalizing the submission. 
• Significantly reduced days sales outstanding (DSO)

Central Management was instrumental in shaping these primeCLAIMS enhancements, aiming to "lighten their load" and speed up reimbursement.

• Revenue Recovery – Module for monitoring and tracking denied claims.
• Flu Roster Billing – A simple import/export template for bulk submission of resident shots
• EzDDE – An easy-to-use DDE editing interface to replace the tedious mainframe DDE

Additional benefits Central Management derives from our primeCLAIMS app and team include:

• SNF secondary claims are more efficiently and effectively processed
• Quick response from SNF/claims knowledgeable team
• Ongoing ability to help shape the app to meet their needs

Above all, Central Management found a tech partner equally invested in streamlining the SNF claims cycle. Not only is our primeCLAIMS app customized for SNF claims, but our support/development team is also. Tenured claims experts handle requests and calls, resolving roadblocks faster and fixing repetitive roadblocks with app enhancements.