Genstler Eye Center, an ophthalmology practice in Kansas, saw the complexity of its billing operations and receivables management increasing as its business grew. Patient volume steadily rose with the practice expanding from three to seven providers, 45 staff members, two satellite offices and a surgery center. Situated in a college town, the practice sees patients of all ages and has a wide payer mix. As the practice grew, so did claim denials and aging receivables—and the burden on administrative staff. 

Managing reimbursement pressure and staff morale

With economic pressures driving down commercial and Medicare reimbursements, Genstler needed to recover every dollar. They knew that devoting operations staff to managing rejected claims and accounts receivable (AR) recovery was inefficient. A billing specialist could easily spend two hours on the phone with a payer to recover only a single low-dollar claim. Working denials and aging receivables put staff behind on daily billing operations, but hiring staff dedicated to aging claims did not make financial sense.