Iris Platform Solution:
Onpoint RCM
Results:
+14%
Professional fee gross rate collection in first 90 days
-8
Days for DNFB + FBNS AR
-3
Months until record high monthly collections
Testimony:
“We have been thrilled with the leadership, expertise and revenue cycle results provided by our OnPoint partners and grateful for the way they shepherded us through tough financial times, post Covid. We’re now partnered with them on growing our Medicaid Managed Care portfolio to improve the Quality of Health in the community we serve.”
Interim Chief Executive Officer
Client Overview
A regional safety-net healthcare system serving the southwestern United States, encompassing:
- Multiple county hospitals, including a Level III Trauma Center
- Three affiliated medical groups, anchored by a high-volume emergency department
- A provider network of 65 employed and 200 affiliated physicians
- Over 500,000 patient visits annually
- A complex payer mix: 45% government pay and 31% Medicaid/Medicare Managed Care
As a critical access provider for a high-need population, this organization faced ongoing pressure to maintain care access while improving revenue cycle outcomes—without adding administrative burden to already strained teams.
The Challenge
With frequent turnover, legacy systems, and disjointed processes, the system’s business office was struggling to keep pace. AR days were high, workflows were fragmented, and core KPIs were consistently underperforming.
The client knew they needed more than just new tech—they needed a full-scale operational reset. With leadership aligned around a push toward HFMA best practices, the system engaged Onpoint to conduct a 6-week RCM Current State Assessment across people, process, and technology. The goal: uncover inefficiencies and identify near-term and strategic financial opportunities across the enterprise.
The Solution
Onpoint deployed its RCM experts to lead a comprehensive, system-wide transformation—restructuring the business office while coordinating revenue cycle optimization across hospitals and medical groups.
Working in close partnership with the client, Onpoint implemented a clinically based RCM model that prioritized accuracy, accountability, and long-term sustainability. The approach centered on measurable KPI improvements and a governance structure designed to foster shared ownership across teams.
Key interventions included:
- Establishing interdepartmental action teams (e.g., DNSP and Billing Governance Teams) to improve cross-functional alignment and ensure process accountability
- Conducting root cause analysis to identify and resolve billing friction between clinical and operational teams
- Designing and standardizing new SOPs and work protocols across the revenue cycle
- Optimizing billing workflows and scrubber software, while improving access to medical records for cleaner, more compliant claims
- Launching a seamless claims submission process powered by accurate, complete clinical documentation
- Improving payment posting accuracy and enhancing compliance tracking to reduce rework and mitigate audit risk
- Introducing real-time KPI dashboards and performance governance tools to drive transparency and sustained results
Onpoint RCM seamlessly integrated into the client’s EHR environment, enabling a more accurate, auditable, and efficient RCM process. The outcome: reduced administrative burden, improved cash flow, and a high-performing revenue operation built to scale.
The Results
- DNFB + FBNS AR days dropped from 15 to 6.8
- Record-high monthly cash collections by month 3, with year-over-year growth by month 12
- Stabilized revenue cycle operations across hospitals and medical groups
- Professional fee gross collection rate increased from 34% to 48% in 90 days
- Consecutive all-time high collections beginning in month 3
