Like many medical practices, at Audubon Women’s Medical Associates you’ll find a room full of boxes, binders, and paperwork. “We have 15–20 binders, one for each provider”, said Kellie Ickowski, Audubon’s Practice Administrator. “I’m excited to get rid of those.”
Located in Buffalo, Audubon Women’s Medical Associates is New York’s largest private group of physicians and nurse practitioners specializing in obstetrics and gynecology. For over 25 years, they have provided healthcare for tens of thousands of women and delivered more than 15,000 babies. And while Audubon may be a large physician group, they, like many others, had previously relied almost entirely on manual processes to ensure appropriate payment from payers.
Kellie and her team knew that obtaining a better understanding of Audubon’s bottom line required focused management of their payer relationships and storing that information in a binder wasn’t enough. They needed help finding efficiencies that could improve their practice’s processes and revenue. That’s when Rivet stepped in.
“We sent Rivet all of our boxes of paperwork, contracts, and fee schedules. Rivet then requested and obtained any missing fee schedules and contracts that we did not have within our records. It was super helpful. Now we have all of our payer contracts and fee schedules organized on one digital dashboard, it is so easy to understand rates and payer relationships. Plus, no more binders.” said Ickowski.
Once they understood their payer relationships, Rivet helped Kellie and her team to compare rates, model fee schedules, optimize their charge master for the most used codes, and prepare them for effective contract negotiations. “We feel confident about the leverage this data gives us and we expect an increase in payer rates on our next round of negotiations.” said Ickowski.
As for their existing contracted rates, Rivet helped to detect underpaid claims from their payers that they could not have identified on their own. “Every once in a while our office would investigate our “big ticket” items to make sure we were getting reimbursed per our fee schedule rates -- especially devices and medications, but we just don't have the manpower to go through and check on everything,” said Ickowski. “Rivet does the background work for us and sends us their findings. It takes away the legwork that we do not have the manpower for in the office.” In Audubon’s most recent report, Rivet detected approximately $10,000 in lost revenue from underpaid claims.
Meeting their goal of making meaningful changes to improve their processes has not only resulted in greater financial transparency at Audubon, but has increased the satisfaction of patients as well as Ickowski’s team, “Overall, There’s a major peace of mind knowing there’s nothing falling through the cracks.”