Texican, Inc. builds sustainable value and financial success for Cerner Revenue Cycle clients

As health systems nationwide respond to increased consumerism, as well as calls for greater health equity and cost reduction, many are attempting to optimize their financial performance to help meet these challenges. Facing constant pressure from high consumer expectations, shrinking margins and growing provider burnout, health systems need strategies that strengthen relationships and build sustainable long-term growth. As many organizations focus on digital front door initiatives, they are finding that patient experience point solutions do not address the underlying revenue cycle processes that are so critical to the patient journey workflow automation in the healthcare revenue cycle is no longer an aspirational element of digital transformation efforts — it has become standard practice for the majority of health systems and hospitals and COVID-19 has placed many healthcare organizations under intense cash-flow pressure and created volatile claim volumes and workloads for revenue cycle teams. These dynamics are driving more revenue cycle leaders to look to workflow automation to provide flexibility and resiliency in their operations while minimizing their organization’s cost to collect.

The Client

 A large, regional, $750M+, non-profit, health-care organization located in the Southern United States engaged
Texican, Inc., to transform its Revenue Cycle Operations (RCO) and to implement process improvement/
standardization across the board. The system consists of seven acute care facilities ranging in size from a critical
access site (25 beds) to a flagship community hospital (475 beds) as well as supporting a teaching hospital and
physician groups/offices.

The Results

Operational Transformation – Driven by Texican’s Life of a Claim

Texican’s Cerner experience and Life of a Claim (LOAC) methodology has achieved the following achievements
across technology, process, and organizational change.

Technology
▪ Reconstructed targeted system and claim data requirements improving first pass pay rate and claim integrity.
▪ Enablement and optimization of CCM & Variation reconciliation
▪ Texican involvement with Cerner solutions development inclusive of Contract Management and 3rd party
integrations i.e., Experian, SSI
▪ Elimination of 10,000’s of weekly recurring edits & bridge routines
Process
▪ Standardized the charge capture process and normalized the charge & coding document process
▪ Reduction in active insurance plan selections
▪ Expansion of telehealth capabilities driving additional Net Cash
▪ Standardized charge capture, coding & billing processes to facilitate accurate reimbursement.
▪ Implemented actionable quality metrics for patient access and scheduling maximizing system capacity.
Organizational Change
▪ Executed on key Health System objectives promoting a culture of People, Service, Quality, Funding & Growth.
▪ Established our client as a premier Cerner client reference site for revenue cycle operations
▪ Inclusion of Texican as a member of the Cerner Revenue Cycle Advocacy Group
▪ Optimized/manage Staff’s efforts in all functional areas of RCO utilizing Texican Life of a Claim Analytics