How Falckon Health helped a Connecticut based lab realize their true revenue potential and helped them achieve 10-fold revenue growth.

Overview

Faced with increasing insurance and patient accounts receivables and failing to realize the laboratory’s full revenue potential, an independent laboratory based in Oakdale, CT offering molecular pathology testing turned to Falckon Health for revenue cycle transformation solution.

Challenges

  • 100% dependency on revenue from in-network insurance payers.
  • >50% of the in-network claims outstanding for over 90 days.
  • Zero collection from claims submitted to out of network insurance payers.
  • Inadequate process to collect on payments paid to patients.
  • Fear of growing  the lab business due to higher concentration of out of network patients in the market.

“Prior to signing up with Falckon Health we were collecting zero from the out of network insurances. Falckon Health team gave us the confidence that we can collect on out of network billing and currently >90% of our business is on out of network insurance billing. We have had the most successful year of 2019 with tenfold growth, this was never achievable without Falckon Health”

Divakar Ahuja – CEO/President – Genesys Diagnostics

How Falckon Helped?

  • Implemented practice management software with personalized optimization.
  • Optimization of fee schedule for better reimbursement from out of network payers.
  • Adapted tested and proven multi-layered collections follow up methodology.
  • Conducted compliance audit and implemented compliance best practices.
  • Introduced HIPAA-compliant document and data management portal.
  • Implemented best practices to collect on paid to patients claims.
  • Introduced efficient negotiation with discount programs (Multiplan).

Results