Finding and correcting underpaid claims are tough, but often essential, tasks in collecting correct reimbursement. In fact, insurers routinely underpay U.S. healthcare providers by an average of 7–11%, according to the Medical Group Management Association (MGMA). And those like Tonia Bateman, Business Office Director at New Mexico Cancer Center (NMCC), have reworked underpayments for years.
With 30+ providers, NMCC offers full cancer care including screening, treatment and survivorship. Patients can even apply for nonclinical assistance through their charity, the New Mexico Cancer Center Foundation.
For a long time Tonia’s team worked with Experian to help with underpayment detection and contract management, even though Experian wasn’t the simplest solution.
“Experian was the best of its kind 10 years ago when we got it,” Tonia said, “but it was really hard to use. I had 5 or 6 staff members go through the training and it was not very user friendly. After a long week of training all day my staff was still confused.”
It was so complex, in fact, that Tonia said she had to get one senior person that could run reports and champion their Experian efforts. “We had to create our own reports to get back the underpayments. It wasn’t user friendly and it didn’t have a good support system,” she said.
Now with over 25 years of industry experience under her belt, Tonia said she was blown away during her Rivet demo.
"I just fell in love with it. I loved the analytics piece, the reporting, that it was so easy to use, that you could drill down different ways, and that it integrated with our practice management system. I knew this is what we had to do and it’s been a great investment for us.”
Tonia compared approximately a year with Rivet to her 10 years with Experian.
“Rivet is 1,000 times easier to use than what we were using before. We started out having two of us using Rivet and now 15 of our staff can use it without the need of formal training. It’s so user friendly. Wherever you need or want to go is, for the most part, self explanatory.”
Like many medical billing experts, Tonia’s team had issues with customer support. But she said with Rivet, “I feel like I have a partner. It's not just a company throwing a software program at me: I have a support team to help me every step of the way.”