Running a medical group is challenging and the providers and staff are often overwhelmed by the many tasks (e.g. enrollment verification, pre-authorizations, working denials (aka hold buckets), patient AR, etc.) required to proficiently manage patient interactions and get paid. The negative effects on a practice can be profound: high turnover among administrative staff; poor reimbursement rates, often less than 90%; and extended payment periods, often exceeding 120 days. The increased complexity of practice management and billing operations, as well as declining reimbursements, is compelling medical groups to seek a better way to acquire efficient Revenue Cycle Management(RCM) processes.
Building the vision for A Better Way
In 2009, Mathew Frazer met a Santa Cruz-based provider going bankrupt due to these challenges. Mathew worked with the provider for two years, and successfully took the practice from its worst year to its best year by leveraging his 25 years experience in technology and investment banking and applying traditional business practices, technology and process knowledge to running the medical group. Today, the practice is tripled the size and still growing by leveraging the athenahealth solutions (athenaCollector, athenaClinicals, athenaCommunicator) and the ABW people, processes and technology.
After consulting with several additional medical groups across the US, and meeting with the athenahealth CEO, Mathew saw the opportunity to build a business dedicated to helping medical groups flourish by better managing the RCM process and leveraging athenahealth. Mathew created a team with a combination of deep RCM expertise, medical practice experience and business/ technology acumen to optimize the athenahealth suite of products. The ABW senior management team have Silicon Valley backgrounds; have been CEOs; worked for Fortune 100 companies; and draw upon their deep RCM experience.
The team chose to focus on the athenahealth platform because they believe in its superior technology and reporting capabilities. ABW works closely with the medical groups and athenahealth to optimize results. The ABW Medical team has 60 years of combined experience on the athenahealth platform and has become one of athenahealth’s leading partners that provides temporary or permanent virtual billing staff supporting the cloud-based platform.
ABW has assembled a team of athenahealth and RCM professionals that remotely perform the day-to-day operations in athenaNet® for over 25 specialties, across a broad range of medical groups including individual and group practices, Federally Qualified Health Centers (FQHCs) and hospitals.
There are more than 60 distinct tasks that medical groups must perform to ultimately get paid. Only one of those tasks is seeing the patient. ABW was formed to take on those other tasks and help the medical group achieve More Revenue, More Time and More Peace of Mind
ABW understands the athenahealth platform and knows how to deliver results.
ABW takes on tasks that bridge the gap for many practices, such as:
• Working hold buckets/denials
• Authorizations and verification of benefits
• Patient/Time of Service (TOS) collection programs
• Coding, charge entry/Missing Slips
• Performs high-volume, low-cost A/R collection
ABW Delivers Results
ABW brings exceptional benefits as providers streamline their operations, significantly reducing recruitment, training and supervision tasks and also reducing operating costs. ABW improves collections, reduces denials from insurance providers and allows denser patient schedules (resulting in more revenue), which lowers administrative costs, and ensures sound regulatory compliance. ABW delivers on its mission of More Revenue, More Time for providers and staff and More Peace of Mind for everyone involved in the practice.
• Collections increased more than 30%
• Denials decreased more than 60%
• Days A/R Outstanding decreased 50% to < 30 days
• 99% of claims fully adjudicated within six months or less
• Provider and Staff spend less time on RCM "grunt work"
• Patient complaints decreased 50%
• More patient throughput with denser scheduling
More Peace of Mind
• Professionally managed processes taught at Stanford and Wharton Business Schools
• Staff morale and efficiency significantly increase
• Providers doing what they love
Growing fast since that first client engagement eleven years ago, ABW has supported over 5,000 providers in 45 states, and recently expanded their positive impact with the inclusion of new core services such as credentialing, expanded patient A/R collections, and practice business analytics.