Case Study

Adventist Health Streamlines Claims Management

Source: The SSI Group, Inc
Adventist Health Streamlines Claims Management

Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.

For Adventist Health System (AHS), an Altamonte Springs, Fla.-based system that operates 45 hospitals, accurate and efficient claims handling is a critical part of both ensuring patients receive the best care possible, and maintaining the financial health of the organization. AHS has deployed a full suite of revenue cycle management solutions, including EDI, billing, and claims management from The SSI Group, Inc. (SSI). Using these tools, AHS has accelerated accounts receivable (A/R) processes and decreased the number of claim denials system wide.

Over the past several years, AHS has converted 29 of its hospitals and home health agencies to the SSI product suite. In addition to improving claims accuracy and billing processes, SSI has also provided assistance in meeting new payer and CMS requirements.

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