Partnership Powered by Results
$1.6M+
recovered from VA claims
100%
payer-notification compliance
16-Hour
average notification time
RESULT
Significant Financial Recovery:
- Recovered over $1.6M from VA claims previously denied due to late 72-hour notifications
Exceptional Compliance Achieved:
- 100% compliance with payer-notification requirements resulting in 16-hour average notification time
Enhanced Operational Efficiency:
- Improved efficiency through streamlined workflows and documentation
CHALLENGE
Notification Process Challenges:
- Systemic problems in the provider’s notification process prompted significant financial losses due to failure to submit timely 72-hour notifications for patient VA claims
Impact on Patient Relationships:
- Delays led to strained patient-provider relationships, as patients faced uncertainties and potential disruptions in their care due to administrative shortcomings
Resource Constraints in Managing Specialized Claims:
- Resources were stretched, preventing the hospital from effectively managing specialized claims
SOLUTION
The health system partnered with Aspirion to streamline VA claims with clean submissions, timely follow-ups, and adherence to the 72-hour notification process using real-time technology to ultimately ensure the following:
Automated Work Queue:
- Claims entered the system via a work queue when patient information is linked to a payer
Rapid Response:
- Notifications averaged 16 hours post-admission, far exceeding the 72-hour requirement
Tracking System:
- Daily reviews ensured proper authorization and complete claim documentation
“Aspirion does a great job. They are definitely experts in their field. The VA is a very complex payer with a lot of rules and guidelines, and it is always evolving and changing and getting more restrictive, but Aspirion stays on top of the changes. The government doesn’t want to pay and is hard to work with. The firm does a fantastic job of staying on top of nuances. Additionally, I am highly satisfied with how the firm performs in motor vehicle accidents. They do a great job with filings and everything. They also have great reports.”
About the Provider
Based in the Midwest, this leading nonprofit integrated health system delivers comprehensive healthcare services across a broad and well-established network. With 10 hospitals, 48 primary care clinics, and numerous specialty clinics, the system is built to meet patients wherever they are in their care journey. Its 2,400 affiliated providers bring a depth of clinical expertise across both primary and specialty care, underscoring the organization’s commitment to accessible, high-quality health services for the communities it serves.