FourPoints Health Paiute Indian Tribe of Utah

FourPoints Health is a medical facility, run by the Paiute Tribe of Utah (PITU), that provides medical, dental, mental, and behavioral health options for the community members, migrant and season agricultural workers and their families, and Paiute Tribe members. Four Points Health prioritizes the needs of tribe members, but its mission is to serve anybody who needs it, according to Shane Parashonts, the tribal administrator for the Paiute Tribe of Utah.

FourPoints Health receives the majority of its revenue from the medical services it bills as a Federally Qualified Health Center (FQHC). In December 2021, PITU’s medical coder left the organization, significantly impacting its ability to generate claims and revenue. CFO Tyler Prisbrey reached out to their Customer Success Manager for help. The CSM recommended athenahealth’s Advisory Services team, which lead to a staff augmentation engagement with a Dedicated Advisor who provides athenaOne optimization guidance and oversight.

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Challenge

  • PITU’s only coder left the organization in 12/2021

  • Coder vacancy significantly impacted revenue

  • Limited billing and coding resources in the area to fill vacancy

  • Limited understanding of athenaOne functionality

  • Significant knowledge gaps and staff turnover

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Solution

  • Recommendation of staff augmentation to fill coder vacancy

  • Role-based training of staff to address knowledge gaps

  • Creation of claim worklists to improve work distribution and client days in AR (cDAR)

  • Standardization for RCM workflows to improve performance outcomes 

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Results

  • Improved charge capture and increased cash collection yield by 17.4% from June 2021

  • Standardized workflows to drive improved cDAR performance

     

Help from experienced coders provides our patients with peace of mind that all services provided to them are being completed accurately and in a timely manner. That trust from a billing/coding perspective is important to a patient, which is why short term help is important to our practice.

These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.