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Mountains Community Hospital

Capturing more revenue

0
%
decrease in AR balance within one year

Mountains Community Hospital had extremely high outstanding accounts receivable (AR) — until Wipfli helped the critical access hospital overhaul its software reporting and staff workflows. With the right tools and stronger processes, the hospital dramatically reduced its AR balance and found stronger financial footing.

The Challenge

Mountains Community Hospital (MCH) didn’t have a denials management process, which led to alarmingly high outstanding AR. Many high-volume payor denials were never adjudicated or appealed, and the hospital’s denials management software was installed but not operational. MCH needed to get its AR systems and process back on track. Wipfli assessed MCH’s denials management protocols to identify areas for high-impact improvement.

The Solution

With Wipfli’s support, MCH:

  • Established a DSG denials management module.
  • Standardized staff processes and reporting.
  • Created a multidisciplinary denials resolution team.
  • Educated staff on payor-specific denial adjudication.
  • Documented staff roles and responsibilities related to AR and created supportive tools and policies.

The results

Wipfli implemented the right tools, stronger processes and targeted training to make AR responsibilities clear and consistent. The hospital’s AR balance dropped nearly 80% within one year, and MCH brings in around $150,000 more per month in cash. The hospital also gained accurate insight into its financial health — and can make more informed decisions about its future.

Services Engaged

Healthcare consulting
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