Specialty : Urgent Care Practice
Service Offering : Full Service Billing
Practice Management Software : Lytec
Client: Urgent care Practice in California
Accounts handed over to ICS: Oct 2018
Business Challenges
Initial Setup
When the practice partnered with I-Conic Solutions, several critical revenue cycle gaps were identified:
- EMR Adoption: The Electronic Medical Record (EMR) system was newly implemented, and staff were still adapting to workflows.
- Total Accounts Receivable (A/R): $532K
- Insurance A/R: $380K of total A/R, with 90+ day A/R at ~65%
- Patient A/R: $152K
- Monthly Collections: $120K
- Average A/R Days: 90 days
Operational Issues
- Denials were not worked on promptly, and denial documentation was inconsistent.
- Patient accounts were disorganized, with statements not generated on schedule.
- Claims follow-up processes were inadequate.
- Co-payment allocations were frequently incorrect.
- Outdated diagnosis codes were being auto-populated by the system.
Only advantage: Immediate accessibility to patient medical records through the EMR system.
Strategic Intervention by I-Conic Solutions
To stabilize and optimize the revenue cycle, I-Conic Solutions implemented a structured recovery and process improvement plan.
EMR Workflow Assessment
Conducted teleconferences with the client to gain a clear understanding of the EMR workflows and identify operational gaps.
Charge Review & Coding Standardization
- Performed detailed charge audits.
- Identified errors related to incorrect modifiers and procedure code usage.
- Established standardized billing and coding rules for the office team.
Claim Filing Corrections
Discovered that certain charges were not being submitted due to technical system issues. These were promptly identified and resolved to prevent revenue leakage.
Rejection Analysis & Reduction
- Analyzed electronic submission reports and rejection reasons in detail.
- Educated the client on recurring errors.
- Implemented corrective workflows that significantly reduced rejection rates.
Patient Statement Optimization
- Designed structured patient statement schedules.
- Initiated regular statement generation.
- Audited and processed all four billing cycles when necessary to prevent A/R buildup.
Patient A/R Policy Development
Developed customized patient A/R policies aligned with the practice’s workflow and financial goals.
Timely Filing & Appeals Management
- Identified claims approaching timely filing limits.
- Performed denial analysis.
- Submitted targeted appeals supported by medical documentation.
Payment Posting Accuracy
Incorrect patient co-payment allocations were identified and corrected to ensure accurate balances.
Diagnosis Code Cleanup
Worked with the software team to eliminate outdated default diagnosis codes that were causing claim issues.
Proactive Reporting & Monitoring
Provided the client with frequent operational reports, including:
- Error reports
- Missing charge (ticket) reports
- Future appointment tracking
These reports improved visibility into patient flow, charge capture, and office performance.
Key Achievements
| Metric | Before | After |
| Total A/R | $532K | $155K |
| Insurance A/R | $380K | $100K |
| Patient A/R | $152K | < $50K |
| Monthly Collections | $120K | $133K–$140K |
| A/R Days | 90 days | 26 days |
Peak Performance:
The highest collections recorded since I-Conic Solutions began managing the account reached $135K within five months.
Conclusion
By partnering with I-Conic Solutions, the practice transformed a highly backlogged and inefficient revenue cycle into a streamlined, high-performing financial operation. Through targeted audits, workflow corrections, and proactive A/R management, the team significantly reduced outstanding receivables, improved collections, and strengthened overall revenue integrity.
