1. By Anita Lacey and Tammy Horne ACT Tulsa, OK

2.  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.

3.  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.

4. 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.

5.  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.

6.  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.

7.  Anita Lacey or Tammy Horne 918.492.2554 alacey@actcares.org thorne@actcares.org