Hawaii Cancer Care: A Case Study

is a community oncology practice in Honolulu, Hawaii serving patients across the islands. Fedora Healthcare Solutions was recommended as a trusted partner to address major gaps by another billing company that included significant missed billings, authorization errors, and lost revenue. Leveraging Fedora’s unmatched revenue cycle management expertise, significant improvement in the financial well-being of the practice was achieved, allowing the practice to increase its buy & bill program and get on a path toward financial stability.

Billing and Charge Posting Overhaul

Fedora immediately reviewed current workflows and prior billing, identifying a sizeable opportunity of missed billings and therefore lost revenue. Fedora began resubmitting claims and missed charges, recovering nearly $300k in the first 90 days.

Authorization Process Optimization

The previous billing company provided incomplete Authorization reviews and did not track validity for ongoing treatments. Fedora deployed our proprietary processes and technology, effectively eliminating missed Authorizations and Authorization denials.

Outstanding AR Cleanup

A sizeable opportunity to systematize and standardize AR follow-up processes existed at the start of the engagement. Fedora stepped in rapidly, collecting on aged AR, corrected posting errors, and implementing routine follow-ups on all claims.

Denial Management and Process Improvement

The practice had an above-average denial rate due to gaps in the front end and charge posting workflows. Fedora organized the denials, identified drivers, and collaborated with the practice to make changes that dramatically reduced the denial rate.

  • Reduced denials by 70% in first 90 days
  • Recovered over $500k in missed billings
  • Increased daily collections by 21%

“Our previous billing company was largely unresponsive and kept making the same mistakes. Fedora’s hands-on, collaborative approach with our team has driven real improvements in our revenue cycle. They are an extension of our team.”

– Isobel Webster, Director of Operations, HCC