FQHCs Boost Revenue Cycle with FinThrive Partnership

My name is Nicki Wilson, and I am the Senior Director here at CTC. CTC stands for Community Technology Cooperative, and I have been here from the very inception.

CTC is an organization that provides Epic EHR to federally qualified health centers, And they actually provide healthcare to the underserved populations across the country. We are located in Massachusetts.

One of the areas that we have seen an improvement for the revenue cycle is with registration related denials.

We've been working very hard to get those denials down because we can use RTE to check registration and coverages prior to the visit. For FQHCs, the patient's coverage can change. What they have today may not be exactly what they have tomorrow. So we have to make sure we're always checking eligibility to make sure we have the correct assistance, whether it be from MassHealth or Medicare, whatever the payer may be.

By doing that, we've seen a great reduction in some of the registration related denials related to coverage mismatch or coverage not found for the patient. As a result of the increased running of RTE, the frequency, we've been able to reduce our three year registration related denials by over six hundred thousand dollars from January of 2024 through December of 2024, which results in more money coming into our FQHCs.

One of the main areas and results that I've seen has been, as I said, RTE, but also from the claims manager and knowledge source perspective.

Specifically with the claims manager and knowledge source, it has helped us a lot with our claims processes, specifically in the reduction of our AR days based on some of the claim errors and outstanding claims of one of our FQHCs. And when I say on the AR days, I'm referring to how long it's taken us from the time we actually send a claim out, see a patient, to being able to actually receive payment back into the system. And that was a result of the claim edit processing and being able to see the edits that are going to hit the payer and having those edits come back and fixing them in Epic before we actually send them out to the claims.

So by doing that, we were able to reduce our outstanding claims by 1.5 million. We were also able to reduce the AR days from 61.5 to 45 days in one year.

From a business perspective, FinThrive has been great for my staff on the IT side of things. But also from my customer health center perspective, it's also been great because of the seamless integration.

Epic, it allows the billing team to work in one system instead of switching through multiple systems. The knowledge source enhanced edits package gives the teams better visibility into pay requirements and reduces the manual interventions. And the overall impact has been optimizing revenue cycle operations and increasing cash flow.