Southern Healthcare Achieves Faster SNF Reimbursement for 10+ Years

Southern  Healthcare Management

Operating 41 skilled nursing facilities located in Florida, Georgia, and North Carolina

Challenge

In the nineties, Southern Healthcare’s accounts receivable (AR) team used several manual preparation, submission, and monitoring processes for claims. It was time-consuming, particularly for some states and payers. In Florida, for example, the demands of managed Medicare payers far outpaced these processes.

Recognizing a need for efficiency, Southern began searching for claims automation systems. But, their initial clearinghouse software didn't yield the anticipated results.

“Before primeCLAIMS, we used an outdated and clumsy system which catered to hospitals. We couldn't get the attention we needed to solve problems. Responses to our support requests were not timely.”

– Patti Bolen, Revenue Cycle Director

Despite this first software investment, updates from payers were still delayed, resulting in incorrect remittance advice (RA), delivery to the wrong place, or even loss of reimbursement.

How primeCLAIMS Helped

Southern Healthcare replaced their tedious hospital-centric software with our SNF revenue cycle software, primeCLAIMS. Due to its ease of use and simple training, their transition to full productivity was significantly shorter.

“Newcomers to Southern Healthcare are amazed by how easy it is to learn and use primeCLAIMS, especially when processing SNF secondary claims. The system is built for senior care providers, and it shows."

–Patti Bolen, Revenue Cycle Director

Beyond its ease-of-use, primeCLAIMS automatically submits claims to payers throughout the day, resulting in faster processing. “We receive confirmation within three hours,” says Bolen. “It allows us to bill faster and expedite the overall turnaround time.”

SNF secondary claims are also easy to track in primeCLAIMS, thanks to dashboard alerts that appear whenever the AR staff logs in. This automation helps Southern get a quicker turnaround with secondary payers, and prevents loss of claim reimbursement due to missed deadlines.

“I highly recommend primeCLAIMS. It offers the tools we need to effectively prepare, monitor, and manage our claims.”

–Patti Bolen, Revenue Cycle Director

Like many of our primeCLAIMS clients, the Southern Healthcare team finds the support excellent. With a collective 40+ years of billing/healthcare experience, our team understands the unique challenges of post-acute claims and the intricate billing details.

Results

Across its many locations, the impact on cash flow was immediate. The primeCLAIMS software pleased staff – and continues to 10+ years later.

• Claims turnaround time significantly reduces days sales outstanding (DSO)
• SNF secondary claims are handled more efficiently and effectively
• Commercial payers reimburse claims faster
• Easier system consolidates all claims for increased efficiency
• Staff obtains quick support responses, even to special requests

Years later, Southern Healthcare Management still relies on primeCLAIMS as its comprehensive SNF revenue cycle management solution for claims.

As one of the early primeCLAIMS adopters, Southern remains instrumental in influencing software upgrades and enhancements to better serve the needs of senior care organizations.