Koha Health supports independent orthopedic and aligned musculoskeletal practices and ASCs in achieving total financial health by addressing both the revenue cycle and strategic concerns that impact organizational value.
Koha Health's client relationships are centered on their core values: integrity, commitment and innovation. Whether strategic or financial, Koha’s clients look to them to meet their goals. Koha’s view on partnership extends beyond their clients to the vendor partners they depend on to fulfill their mission. The trust their clients place in them extends to their partners which is why they view trust as critical to their vendor relationships. This trust and fit were pillars that launched the relationship between Koha and RCxRules 12 years ago. Koha and RCxRules’ shared dedication to customer success paved the way for the partnership.
“Koha Health implemented RCxRules over 10 years ago and today it is a core component of our RCM business. The length of the relationship and ongoing success prove the stability and vision of the product. In addition to the product, our relationship with the RCxRules team from Sales to Account Management to Support to Development continues to be an enjoyable experience”
— Chris Fay, Chief Information Officer
The Challenge
As Koha Health has grown over the years, the complexity amongst their customers has increased. More demanding government initiatives and always-changing insurance requirements have made it difficult to control costs and achieve high accuracy at the same time.
Historically, prior to activating new clients, extensive management and staff hours were needed to fully understand a customer’s specific requirements, making it more and more challenging to take on new groups. Koha Health needed to expedite and simplify this process without sacrificing its proven quality of service. Their goals included bringing new practices live faster, reducing dependency on expert staff, and improving financial results for its customers.
The Solution
Koha Health partnered with RCxRules to implement a single-platform rules engine for all of their clients. Their clients use a variety of EMRs, and RCxRules’ vendor-neutral approach creates a consistent charge interface that works with virtually any system.
The RCxRules Revenue Cycle Engine automatically reviews 100% of encounters entered into the EMR and clinical systems used by Koha Health’s clients—then automatically fixes routine data quality issues while directing exceptions to staff before they reach the revenue cycle management system. The rules engine acts as a collective knowledge base for each client, eliminating the need for Koha Health staff to learn and organize each client’s unique criteria and information on their own.
The Results
By implementing RCxRules software, Koha Health achieved:
• A 65% automation rate, the equivalent of 6 FTEs
• 66% earlier go-live dates for new clients, allowing them to begin billing as early as 30 days after contract signing
• Denial rate under 2% and A/R days cut from 45 to 33 due to the automated operational shift from back-end resolution to front-end prevention
“With RCxRules, we have dramatically reduced denials and improved staff efficiency. This helps us continue to improve the level of service we provide to our physician customers, which is essential given today’s competition. I don’t see how we could produce these results without RCxRules.”
— Brad Cox, Vice President of Revenue Cycle Operations
Find out how other large medical groups use RCxRules software to boost efficiency by exploring these success stories.
