Case Studies

Northeast Health Systems: Beverly Hospital


Hospital Facts:

  • Full service community hospital
  • 221 Beds
  • Services include maternity, pediatrics, surgical, cardiology, orthopedics and other specialties
  • More than 570 physicians serving 13 communities in and around Beverly, Massachusetts
  • Large Medicare population

Challenge:

  • Significantly improve Medicare claims performance
  • Ensure compliance with changing Medicare requirements, especially unpublished edits
  • Screen for medical necessity more effectively

Results:

  • Reduced days in A/R by up to 3 days translating to $2 million in cash flow
  • Decreased labor costs by $100,000
  • Significantly decreased overall number of denied Medicare claims
  • Streamlined claims compliance process

Solutions: