Supporting Contracted Providers with Dedicated RCM Services

Client Spotlight: County of Santa Clara Behavioral Health Services

The RCM Services Impact

A strong knowledge of denials and system configuration was the foundation for supporting claims processing for contracted providers. The Netsmart RCM team offered a thorough understanding of denial issues specific to contract providers and gave guidance on corrective measures. Additionally, the testing support for MSO claims processing within the CalAIM system configuration was critical. As a result, the Netsmart RCM services team enhanced the efficiency of upfront troubleshooting for contract provider billing issues.

 

Additional outcomes of this project include:

• Reduced average days to process claims to less than 2.5 days from receipt*
• Developed KPI reporting and trending, delivered monthly
• Established dedicated email for contract providers to email billing questions

 

“The Netsmart RCM team has been instrumental in processing claims coming into MSO from our contracted providers. The team communicates very well, provides data upon request, follows a very structured workflow to mitigate potential errors, and have proven to be great collaborative partners.”

Aaron Weinstein, Program Manager III, Behavioral Health Services Dept., County of Santa Clara Behavioral Health Services

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*Comparing pre-go-live average data from December 2022 and January 2023 to post-go-live average data from February–October 2023.