By Anita Lacey and Tammy HorneACT

Tulsa, OK

The accounting department sought to increase Medicaid collections by $300,000.

Current collections were $665,000, making the goal $965,000 total.

Medicaid is 12.5 percent of ACT’s revenue.

Anita Lacey identified 14,970 claims denied by Medicaid over two fiscal years to research, correct and resubmit.

She identified that more than 90 percent of the denials could be resubmitted. A spreadsheet was developed to make tracking paid and denied claims easier.

This was accomplished with $20,000 a year in overtime and no additional staff members. Today, no denial is more than 90 days old, and Lacey manages the project without overtime.

No denial more than 45 days old and denial rate of less than 15 percent

Train & remind clinicians & accounting staff to double check names, member numbers, and authorization locations as records are created.

Improved cash flow for the agency by adding $1 million in collected revenue

Improved Medicaid billing processes will sustain Medicaid collections of at least $1 million in FY11, a 45 percent increase over when the project began.

Denials have decreased from 35 percent in FY08 to 17.5 percent today.

Anita Lacey or Tammy Horne

918.492.2554

alacey@actcares.orgthorne@actcares.org