Challenge:
Smile Partners is a DSO headquartered in Troy, MI that currently services over 100 practices across 5 states. Seeking a solution to enhance their centralized billing operations, their leadership looked to test an efficient system capable of supporting their ambitious expansion objectives.
Their existing billing methodology lacked an automated digital patient follow-up mechanism, which led to a lag between when statements were eligible and when they were paid. Like many DSOs, their RCM team relied on the dependable, albeit slow, method of sending batched reports for mailing statements on a monthly basis.
Their RCM team identified a need for a unified system to improve patient accounts receivable (A/R) collections to help them match their pace of growth.
With past-due patient A/R escalating and surpassing their manpower capabilities, Smile Partners emphasized the need for automation to reach their growth objective of surpassing their 100th location within a 12-month span.
Solution:
Smile Partners had existing patient communication and intake solutions that had some overlapping "RCM" type of functionality; however, they were drawn to Pearly as a more comprehensive solution specific to patient A/R management.
Pearly’s ability to use multiple data sources including pending insurance claims, patient billing types, and even ledger-level procedure code information to trigger large-scale billing follow-up gave it a unique position in Smile Partner’s suite of software.
At the organizational level, their RCM team could define and tailor the billing rules and criteria according to their individual needs of each location. Pearly users could continue to make changes to outreach to improve performance.
Through high-resolution filtering and sending thousands of itemized and transparent billing notifications daily to patients, Pearly gave Smile Partners the tools to scale their collection efforts as they scaled the size of their organization.
Impact:
Within the initial 45-day period, Smile Partners saw a significant decrease in patient portion A/R, collecting $1,116,000, including $458,000 that was over 90 days overdue.
Notably, over 40% of patients engaged and billed through Pearly settled their dues within this timeframe. This result demonstrated a quick adoption rate among the Smile Partners patient base.
Since their pilot program, Smile Partners has consistently integrated new locations into the Pearly system shortly after each acquisition, demonstrating seamless scalability. By applying detailed billing and blocking rules, their RCM team efficiently replicates existing configurations/ This best practice facilitates swift collections from newly acquired offices.
By using Pearly, Smile Partners now sees a reduction in total outstanding A/R balances by over 30%, underscoring long-term financial efficacy.
