Prospect Medical Benefits From 300-500 Fewer Denials Per Month With A/R Optimizer

Before FinThrive

Legacy systems failed to capture a comprehensive and accurate picture of claim denials

Denials not tied to contract management process

False positives, duplicate denials and secondary insurance issues

Lack of consistent reporting definitions and methodologies across facilities

Solution Highlights

A true remaining balance using expected contractual amount and detecting denials

Payer scorecards to facilitate better negotiation with payers

Reimbursement analyzer to review what’s left at a line-item level

Underpayment and denials management

Customer Overview

Prospect Medical Holdings is a significant provider of coordinated regional healthcare services in Southern California, Connecticut, New Jersey, Pennsylvania and Rhode Island

↓3.6%

Reduced inpatient denial rate from 17.2% to 13.6%

300-500

300-500 fewer denials per month for outpatients

$10M

One facility benefited from $10 million less denied dollars than the previous year