Iris Platform Solution:
Onpoint RCM
Results:
+17%
Gross collection rate improvement
+10
Point increase in clean claim rate
-50
Day average AR reduction
Testimony:
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Client Overview
A county-based hospital medical group in the western U.S. engaged Onpoint to transform its underperforming revenue operations. The group includes:
- Three hospitals, anchored by a Level III Trauma Center
- 25 specialties, including emergency department services
- 169,000 annual patient visits across all entities
- An EHR ecosystem built on Meditech Ambulatory, with Change Healthcare scrubber
- A payer mix of 55% government-pay and 31% Medicaid/Medicare Managed Care
The Challenge
After successfully overhauling its hospital-side revenue cycle, system leadership turned its attention to the medical group—where performance lagged significantly.
An Onpoint Current State Review (CSR) surfaced troubling metrics:
- Days in AR exceeded 130
- Over 60% of AR was aged 90+ days
- Gross cash collection rates hovered at 31–34%
- The contracted billing vendor showed inconsistent execution and limited accountability
The group needed a fast, strategic fix—and a partner with deep experience in clinical and operational revenue cycle design.
The Solution
Onpoint implemented a phased, hands-on approach to transform professional billing operations across the enterprise—beginning with a targeted cash acceleration effort focused on aged A/R. Within 91 days, Onpoint assumed full ownership of medical billing responsibilities and restructured workflows across departments to improve efficiency, accountability, and outcomes.
Key components of the transformation included:
- Stabilizing and restructuring the medical group’s billing operations to restore consistency and throughput
- Implementing a comprehensive SOP framework and unified work standards across all entities
- Redesigning the claims submission process with an emphasis on front-end documentation quality and scrubber optimization
- Augmenting staff resources to support operational continuity during the transition
- Strengthening payment posting compliance and tracking protocols to reduce leakage and improve audit readiness
- Mapping end-to-end workflows and introducing real-time performance dashboards tied to actionable KPIs
- Establishing a team-based governance model rooted in clinical insight and operational alignment
- Improving access to integrated clinical documentation to support cleaner coding and faster reimbursement
With Onpoint RCM embedded into daily operations, the client achieved more than an outsourcing solution—they built a clinically intelligent revenue engine.The result is faster claims, higher compliance, and a scalable foundation for long-term revenue integrity.
The Results
- Average AR Days reduced by 50 within four months
- Record-high monthly cash collections achieved in month 4—and sustained every month since
- Gross collection rate improved from 31–34% to 48–51%
- 10-point increase in clean claim rate
