Enhancing Compliance and Reducing Denials for Tarheel Surgical Supplies
Discover how QHS supported Tarheel Surgical Supplies by implementing effective compliance systems, reducing denials, and improving payment processes.
Tarheel Surgical Supplies specializes in serving patients with diabetes and related complications. Their focus on providing essential medical supplies makes them a trusted partner in improving the quality of life for their beneficiaries.
The Problem
Tarheel Surgical Supplies faced significant challenges related to payment delays caused by prepayment payer audits and issues with patient resupply orders. These complications hindered their cash flow and created administrative burdens that impacted their operations.
Goals to Achieve
- Implement a compliance system to streamline patient follow-up activities and maintain necessary medical records.
- Ensure continued reimbursement for recurring supply orders through proper documentation.
- Educate patients and referral sources on compliance requirements to prevent payment disruptions.
Our Solutions
QHS worked closely with Tarheel Surgical Supplies to address these challenges by:
- Developing a system to verify eligibility services prior to dispensing necessary supplies.
- Establishing clear and compliant contact methods with beneficiaries and referral sources to ensure smooth processes.
- Providing training and resources to educate patients and referral sources on proper documentation requirements for continued reimbursement.
The Results
With QHS’s support, Tarheel Surgical Supplies achieved:
- A significant decrease in claim denials and payer recoupments.
- Enhanced compliance processes, preventing backend claim issues through proactive measures on the front end.
- Improved patient and referral source awareness of documentation requirements, ensuring smoother operations and consistent reimbursements.
J.F. Herlocker
Owner, Tarheel Surgical Supply, LLC
“I have had the pleasure of working with Quality Healthcare Systems for almost 4 years, and I wholeheartedly recommend them to any business seeking a reliable and efficient medical billing partner. One of the standout qualities of QHS is their responsiveness and willingness to go the extra mile to address concerns and inquiries promptly. Their dedication, professionalism, and personalized approach make them an asset to any organization in the healthcare industry.”
