Client Profile

• Name: Heal 360 Primary & Urgent Care
• Location: Plano, Allen, and Wylie, Texas
• Specialty: Holistic Urgent and Primary Care Medicine
• Services: Primary care, urgent care, chronic condition management, wellness programs

Business Challenges

Heal 360 Primary & Urgent Care aimed to stay ahead of patient needs while delivering a compassionate and holistic approach to medicine. However, they encountered several obstacles in their revenue cycle management (RCM), which created strain across various parts of the practice. Key challenges included:

• Limited Financial Visibility and Analytics: Heal 360 lacked the financial insights needed to make timely, data-driven decisions. Without regular, clear reports on revenue patterns, denial trends, and cash flow, the clinic couldn’t adequately plan or predict financial performance, hindering proactive business decisions.
• Delayed Payments and Reduced Revenue: With delayed reimbursements from insurance providers and complex claims processes, revenue generation was slower than expected. This impacted the clinic’s ability to reinvest in resources, which ultimately hindered growth.
• Increased Administrative Burdens and Staffing Costs: Due to the need for meticulous claims and payment follow-up, Heal 360 staff spent significant time handling administrative tasks, leading to increased staffing costs. Their focus was increasingly split between back-office tasks and patient care, creating a pressure that wasn’t sustainable.
• Decreased Focus on Patient Care and Satisfaction: The increase in administrative work drew attention away from patient-centered tasks, which impacted patient satisfaction. The team struggled to give patients the seamless, efficient experience that they envisioned, and this imbalance began to impact retention and loyalty.
• Inefficient Claims Processing and Denial Management: With frequent insurance denials and lengthy appeal processes, Heal 360 encountered a large volume of unresolved claims. These inefficiencies stalled cash flow and led to time-consuming rework by the billing team, pulling them further from their core mission.

Strategic Solution

To address these challenges, Heal 360 engaged QZ Medx, a leading medical billing company known for its deep RCM expertise and commitment to driving revenue for healthcare providers. QZ Medx implemented a tailored revenue cycle management strategy that encompassed the following elements:

• Staff Training and Support: QZ Medx trained the Heal 360 team on best practices for patient registration, pre-authorizations, and front-end RCM tasks, creating a stronger, more knowledgeable team capable of supporting a streamlined revenue cycle.
• Claims Processing and Submission: QZ Medx took ownership of the claims process, from initial submission to follow-up, ensuring claims were processed accurately and quickly. Their team prioritized clean claims submissions to avoid rejections and expedite payments.
• Insurance Verification and Credentialing: QZ Medx established a robust insurance verification process that enabled Heal 360 to confirm patient eligibility and benefits before appointments, preventing denials and out-of-pocket surprises. They also streamlined credentialing, enabling the clinic to add new providers with ease.
• Payment Posting and Revenue Cycle Management: Through QZ Medx’s structured payment posting practices, Heal 360 was able to accelerate revenue collection and gain insight into payer payment patterns. Their end-to-end revenue cycle management support ensured consistent, accurate tracking of financial transactions.
• Denial Management and Appeals: QZ Medx established a proactive approach to denial management, addressing root causes and implementing real-time corrections. They not only managed denials but also spearheaded appeals, winning previously lost revenue for Heal 360.
• Regular Financial Reporting and Analysis: By providing monthly financial reports, QZ Medx enabled Heal 360 to access clear, actionable insights into their revenue cycle performance. This visibility empowered Heal 360 to make data-driven decisions and strategically plan for growth.
• Customized Billing and Coding Optimization: With deep knowledge of industry codes and payer policies, QZ Medx provided Heal 360 with coding support tailored to their specialty. This increased billing accuracy and compliance, ensuring Heal 360 received proper reimbursement for every service rendered.

Major Results

With QZ Medx’s expertise, Heal 360 achieved:

• $800,000 in annual revenue growth (33% increase)
• 95%+ clean claims rate (25% improvement)
• 99%+ first-pass payment rate (15% improvement)
• 30% reduction in days outstanding (average 45 days)
• Improved cash flow and financial stability
• 6. 95% patient retention

Key Benefits

• Increased Revenue: By addressing claims errors and denial management head-on, QZ Medx helped Heal 360 capture revenue that would have otherwise been lost. Their meticulous approach ensured that all services were billed and reimbursed correctly and on time, allowing Heal 360 to enjoy consistent revenue growth.
• Reduced Administrative Burden: With QZ Medx managing critical RCM tasks, Heal 360’s staff could focus on their passion: patient care. The reduction in administrative workload not only improved efficiency but also lifted staff morale, fostering a more supportive, patient-centered environment.
• Improved Financial Visibility: QZ Medx’s detailed reports allowed Heal 360’s leadership to monitor performance metrics, spot trends, and make informed financial decisions. This real-time financial insight was a game-changer, enabling proactive planning and goal setting.
• Higher Patient Satisfaction: Simplified billing procedures reduced patient confusion and inquiries, while a seamless claims process meant fewer billing delays. Patients were more satisfied, trusting that Heal 360 would handle their care and billing with transparency and respect.

Testimonial

About QZ Medx

QZ Medx is a premier medical billing company in Minnesota, with over a decade of RCM expertise and a dedication to enhancing healthcare providers’ revenue. Known for its personalized approach, QZ Medx delivers:

• Advanced Technology and Analytics: Leveraging cutting-edge software, QZ Medx offers insights and tracking tools that empower clients to make data-driven decisions, improve processes, and strengthen financial outcomes.
• Experienced RCM Expertise: With years of hands-on experience, QZ Medx has an in-depth understanding of RCM challenges, helping clients overcome them with confidence.
• High-Quality Work and Professional Resources: QZ Medx is committed to excellence, providing clients with resources to ensure every claim is accurate, timely, and compliant.
• Revenue Growth Focus: QZ Medx prioritizes maximizing revenue, supporting clients in achieving financial stability, and helping them reinvest in their practice.
• Personalized Service and Support: Every client receives custom-tailored service, with a QZ Medx team member ready to address specific needs and adapt to changes as they arise.

QZ Medx Contact Information

Email: info@qzmedx.com

Phone Number: +1(507)514-8461

For more details: Visit our website