What seemed manageable at first quickly spiraled into a billing nightmare for Addie Bristol, practice manager at Bristol Family Eyecare. She initially thought she might be able to pick up the slack after the practice’s long-time billing person left. But she quickly realized that not only had the job been too large for a self-taught biller, it was way too big for her to incorporate into her daily duties. She was sorting through piles of unfiled insurance claims, chasing down co-pays that may not have been collected or posted and wrestling with denials she barely understood.
“By the time our biller left, our accounts receivable (AR) had ballooned to more than $600,000. We were nowhere near our goals: 80% of our AR was stuck over 30 days when we aimed for less than 40%, and only 47% of our AR was under 90 days, well shy of the 85% target,” Bristol says.
That was the breaking point. To keep the three-location, five-OD practice near Austin, Texas, moving along, Bristol and her husband and practice founding member, Dan Bristol, OD, MBA, had to make a change. Although she had tried to recover what she could, she was also determined not to let mistakes and oversights build to this level again. The practice signed on with HELIX’s Revenue Cycle Management (RCM) services.
Almost immediately, HELIX embedded its experts in the practice’s Compulink cloud system. Each night, the HELIX team files claims, runs exception reports and flags issues. These could include missing diagnosis codes, patient-insurance mismatches or eligibility errors. Every morning, Bristol’s designated liaison receives a concise report: which claims posted, which bounced and why.
CONTINUOUS COACHING
To streamline communication, Bristol Family Eyecare assigns one in-house coordinator to work directly with the HELIX RCM team. They hold monthly review meetings where the HELIX team identifies recurring front-desk mistakes and suggests system tweaks—everything from data-entry protocols to denial-prevention rules. “They’ll say, ‘Your front desk person isn’t entering some insurance information correctly—here’s how to fix it,’” Bristol says. “That ongoing coaching helps us sharpen our own workflows.”
With HELIX RCM’s guidance and oversight, denials dropped dramatically. Automated checks catch simple errors before claims leave the system, allowing corrections to be made before the claim is submitted and potentially denied. Plus it’s all clearly communicated to the practice. They see claims filed, payments posted and patient balances, all with notes that make it easy to answer questions quickly.
The results speak for themselves: AR over 30 days plummeted from 80% to just 12%. That’s an 85% reduction in aging AR. “With HELIX RCM, we are well within the goals we set for our AR,” Bristol says.
IMPROVED PATIENT EXPERIENCE
For the practice, faster claim processing means quicker payments and far fewer write-offs. But it’s also important to patients that billing is handled correctly and clearly. Patients now receive timely, transparent statements instead of sporadic bills that formerly confused them. “If someone calls about a $55 deductible, for example, our team can pull up the RCM note and explain immediately. There’s no chart digging required,” she says. That clarity has reduced patient inquiries and boosted satisfaction.
CREDENTIALING HELP
Support from HELIX RCM extends to credentialing new doctors, too. That’s vital as the practice expands its referral stream from the Veterans Administration and other insurers. HELIX helps the practice “keep a pulse on each provider’s panel status and flag anything that might delay claims,” she says.
Ultimately, the shift to using HELIX’s RCM services has provided Bristol Family Eyecare with financial stability. The main clinic continues to grow, and the two satellite offices they’ve acquired have both tripled their revenue since acquisition. And the one person on staff who coordinates with the RCM team maintains a manageable workload. That also allows her to do some scheduling and insurance verification on the front end, adding even more efficiency. “We went from drowning in paper to confidently growing our practice.”
The other result is peace of mind that comes with knowing that billing is handled correctly, omissions or errors are caught early and patients get clear statements. She encourages other practices with billing and coding frustrations to try outsourcing RCM. “It was the best decision we made. Give it three months, and you’ll see the difference for yourself.”
Want to learn more about HELIX’s RCM service? Schedule some time to talk with the team.
