CUSTOMER STORY
Antelope Valley Medical Center
When patients are discharged to a post-acute care facility, it’s crucial for health systems and hospitals to identify claims that failed to transfer under Medicare’s post-acute-care transfer (PACT) rules. Without this identification, hospitals could be at risk for underpayments—losing money that rightfully belongs to them. In fact, underpayments for Medicare include a shortfall of $75.6 billion, meaning hospitals receive payment of only 84 cents for every dollar spent by hospitals caring for patients with Medicare.
The Search for Lost Payments
Antelope Valley Medical Center was looking to improve their Medicare underpayment recovery (MUR) and transfer diagnosis-related groups (DRG) solution. “We knew there was room for improvement in the amount of money that we could capture,” said Brenda Martinez, Business Office Billing Manager.
Not only was their old MUR/transfer DRG solution slow, it didn’t meet their customer service needs. “They were not asking us for our accounts; they were just taking them,” Martinez recalled about their former partner. “And they were not responding to any of our messages. . . . It left us feeling taken advantage of.”
That’s when their revenue cycle director found Office Ally. “The customer service at Office Ally is fantastic and has been from the very start,” Martinez said. “Our Office Ally representative is very honest and understanding, and the program is fast and transparent.”
A History of Success and Trust
Having been “burned badly” by their previous MUR/transfer DRG solution, the Antelope Valley Medical Center team felt hesitant to work with a new company. However, they were pleased to find the Office Ally team has a storied track record of success. “They’ve been around for more than fifteen years, and they are a well-known name and a trustworthy partner, ” Martinez said.
The revenue cycle department was impressed by the Office Ally team’s achievements, including $2 billion in under payments recovered and 99.89 percent paid claims success rate, along with their commitment to quality service. “No upfront fees and their commission policy also means so much to us. I just feel that they are there for us, no matter the question we have or item we need,” Martinez added.
A True End-to-End Process
Between their deep understanding of the Medicare system, rules, and regulations and the true end-to-end process, Office Ally helps hospital teams save time and work more efficiently. “With this type of recovery, we don’t really have to do much,” Martinez said. “We just send account information and then Office Ally does all the rebilling. They do everything and we just get the money.” The process is quick, easy, and efficient—and, according to Martinez, the customer service is “truly exceptional.”
Martinez also enjoys the level of detailed reporting. Office Ally provides client-level access via dashboard of eligible underpayment claims so the process is not only fast, but transparent. “We can see everything and know Office Ally is there and actually working for us,” she added.
A Great Benefit to Business
Antelope Valley Medical Center is happy that partnering with Office Ally enables them to recover payments that would’ve otherwise been lost. From retrospective filing to due diligence to detailed reporting, this MUR/transfer DRG solution is helping the team recover money at a rapid rate. “Office Ally is a great benefit to our business,” said Martinez. “We’ve received additional reimbursement for patients we never would’ve known without it. I would recommend it to anyone!”
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Medical Billing | Capterra.com
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