SITUATION
The vice president of revenue cycle for a large West Coast-based health system, a longstanding R1 customer, was looking for ways to make her team more efficient and improve revenue recovery. In her quarterly business review, she challenged R1 to suggest ways to expand success across existing solutions.
SOLUTION
Based on early success with an underpayments safety net coverage detection solution, R1 suggested piloting the new Insurance Discovery solution across the full health system. R1 and the VP of revenue cycle aligned on goals, tested initial results and provided proof of value in recoveries. In partnership, the customer also offered product feedback on the solution, improving results for the product and her own organization.
RESULTS
Within eight months of go live, the health system and R1 recovered $1.2 million through Insurance Discovery – more than 5x what was recovered by the previous coverage detection tool. Recoveries in the first full year were $3.5M and the health system is on track to recover more than $5 million this year.
$1.2M
recovered in first eight months
+5X
more recovered with R1 compared to previous tool
$3.5M
in recoveries in the first full year
“R1 worked closely with customers, including three of the nation’s top 10 health systems, to develop a new way to find missing coverage, return the findings to the EHR and capture more revenue.”
VP, Insurance Discovery and Payer Services
