RP Sanjiv Goenka Group

Elevate and Transform: Pain-Free RCM Solutions for New England’s Healthcare Pioneer

A prominent healthcare group in New England, offering a wide range of services including Pathology, Radiology, Oncology, and Anesthesia, sought to elevate their Revenue Cycle Management (RCM) processes. With the ambition to not just replace but significantly upgrade their RCM vendor, they launched a Request for Proposal (RFP) aimed at finding a partner capable of bringing innovative solutions for their multiple challenges across the various specialties. The formidable RFP turned into an obsessive target to prove Firstsource’s capabilities in taking on large multi-dimensional challenges.

Here’s how we helped them overcome every one of their challenges using technology and tailored strategies:

Challenge 1:

Migrate all specialties in one go.

Solution:

Firstsource established a dedicated task force and governance team to meticulously plan and execute the migration process. Leveraging our proven transition and onboarding templates, we ensured a seamless transition for all specialties, minimizing disruptions and maximizing efficiency.

Challenge 2:

Build a concurrency module for Anesthesia.

Solution:

Recognizing the critical need for a specialized solution, Firstsource developed a one-of-its-kind concurrency module for Anesthesia. It was a first for an RCM (non-PMS) company to build, own, operate, and transition (BOOT!!) an anesthesia concurrency module. Through rigorous research and development, we designed a customizable and intuitive platform tailored to the unique requirements of anesthesia billing.

Challenge 3:

Deploy autonomous coding for Radiology.

Solution:

Leveraging AI and machine learning, Firstsource introduced an autonomous coding system for Radiology. This advanced solution not only improved coding accuracy but also enhanced operational efficiency and revenue capture for our client.

Challenge 4:

Use a native (legacy) EHR for Oncology coding.

Solution:

Collaborating closely with the group, Firstsource seamlessly integrated native EHR systems for Oncology coding. Through customized interface build and data integration processes, we facilitated efficient coding workflows while ensuring compliance with industry standards and regulations.

Challenge 5:

Provide a transition guarantee.

Solution:

Firstsource ensured a smooth transition by guaranteeing that the average of the first 3 months collections would not fall below the average trailing twelve months. Through meticulous planning, rigorous testing, and proactive communication, we successfully mitigated risks and ensured continuity of revenue streams during the transition period.

Challenge 6:

Provide performance guarantees.

Solution:

Firstsource committed to performance guarantees, including increasing collections by 3% in Year 1 and further increasing that number by 5% in Year 2, indicating the long-term effectiveness of our strategies. By implementing robust performance monitoring mechanisms and continuous improvement initiatives, we surpassed these targets, delivering tangible value and ROI for our client.

The figures below tell you the entire story that we are extremely proud of achieving.

Firstsource’s partnership with this major New England healthcare provider highlights our success in boosting financial and operational efficiency through our customized, innovative RCM solutions. If you want us to elevate and transform your revenue cycle management.

Business impact

Improved patient access to services and insurance benefits


< 4 months

Gained Medi-Cal coverage for 500+ patient accounts


> $400,000

Uncovered in additional Medi-Cal eligible charges


2X

Increased cash collections in just six months


$1.9M

Resolved ongoing patient case

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