Success Stories

How Outsourcing Transformed Claims For an LTC Pharmacy?

Background: Operating in a high-demand environment, this LTC pharmacy struggled to manage its patient data and claims processing workflows effectively. The pharmacy’s administrative team was bogged down by manual processes, errors in data entry, and complex claims requirements. These issues not only led to operational inefficiencies and higher costs but also hindered patient care by delaying treatments and medications. Realizing the need for a change, the pharmacy partnered with Staffingly, Inc. to address these issues through tailored outsourcing solutions.

Challenge:

The pharmacy’s challenges were multifaceted:

1. Data Management: Inefficient handling of patient data meant that critical information was often delayed or incorrect, leading to errors in medication administration and treatment planning.
2. Claims Processing: Complicated and slow claims processes resulted in delayed reimbursements from insurance providers. This inefficiency increased administrative costs and placed additional financial strain on the pharmacy.
3. Impact on Patient Outcomes: Errors and delays in patient data management affected the speed and accuracy of care delivery, impacting the pharmacy’s reputation and patient satisfaction.

Solution:

To address these challenges, the LTC pharmacy collaborated with Staffingly, Inc., which specializes in healthcare outsourcing services. Here’s how Staffingly helped transform the pharmacy’s operations:

1. Customized EMR System: Staffingly implemented a tailored electronic medical records (EMR) system specifically designed to meet the unique needs of LTC pharmacies. This new system provided streamlined data organization and easy access, reducing errors and allowing staff to retrieve patient information more efficiently.
2. Outsourcing (BPO) Model: By outsourcing data management and claims processing to Staffingly, the pharmacy could refocus its in-house staff on core patient care tasks. Staffingly’s team, trained specifically on the client’s systems and workflows, handled these tasks with precision and speed, ensuring that patient data and claims were processed seamlessly.
3. Training for Smooth Integration: To ensure a smooth transition, Staffingly conducted extensive training for its team on the client’s systems and workflows. This preparation was key in minimizing disruptions and maintaining operational continuity.

Outcome:

The partnership with Staffingly led to tangible benefits:

• Improved Efficiency: With streamlined processes, the pharmacy experienced a more organized and reliable approach to data management and claims processing. Staff could now access patient information quickly and with fewer errors, enhancing care delivery.
• Significant Cost Savings: The pharmacy achieved a 50% reduction in administrative costs, a result of reduced labor requirements and streamlined workflows through outsourcing.
• Enhanced Patient Outcomes: By improving data accuracy and accessibility, healthcare providers could make better-informed treatment decisions, leading to faster medication administration and improved patient satisfaction. Within the first year, patient satisfaction rose by 20%.
• Financial Gains: Timely claims processing improved reimbursement rates, leading to a notable boost in the pharmacy’s overall revenue.
• Long-Term Partnership Success: Pleased with the results, the pharmacy expanded its partnership with Staffingly, entrusting additional administrative tasks to their outsourced team. The relationship has continued to grow, benefiting both businesses.

Frequently Asked Questions (FAQs)

Q1: Why should a pharmacy outsource patient data management and claims processing?
A: Outsourcing allows pharmacies to delegate time-consuming administrative tasks to specialized teams, freeing up in-house resources to focus on core patient care. With experts managing data and claims processes, pharmacies can reduce errors, accelerate workflows, and improve efficiency.

Q2: How does outsourcing impact patient outcomes?
A: By outsourcing data management and claims processing, healthcare providers can ensure faster and more accurate handling of patient information. This enables healthcare providers to make timely, informed decisions for patient care, leading to better outcomes and higher patient satisfaction.

Q3: What kind of training does Staffingly provide to its staff for handling client-specific systems?
A: Staffingly provides comprehensive training to its team members, tailored to each client’s unique systems and workflows. This ensures a smooth transition and integration, with our staff operating as an extension of the client’s team from day one.

Q4: How does Staffingly ensure data security and HIPAA compliance?
A: Staffingly, Inc. follows strict HIPAA compliance protocols and employs advanced security measures to protect patient data. Our staff undergoes regular HIPAA training, and we use encrypted communication channels and secure storage to maintain the highest data security standards.

Q5: What specific tools and technologies does Staffingly use to streamline pharmacy operations?
A: Staffingly utilizes industry-leading tools such as FRAMEWORK LTC, COVER-MYMEDS, and ECM to optimize prescription processing, claims management, and data handling workflows. These tools improve accuracy and reduce the time spent on administrative tasks.

Q6: How quickly can a pharmacy expect to see results after outsourcing to Staffingly?
A: Many of our clients begin to see improvements within the first few months of outsourcing. For example, the LTC pharmacy in this case study saw a 50% reduction in administrative costs and a 20% increase in patient satisfaction within the first year.

Q7: Can outsourcing with Staffingly reduce denial rates for insurance claims?
A: Yes, Staffingly’s experienced team can significantly reduce denial rates by ensuring that claims are accurate and submitted with the necessary documentation. We work closely with healthcare providers to handle appeals and follow-ups, improving overall reimbursement rates.

Q8: What other healthcare outsourcing services does Staffingly provide beyond data management and claims processing?
A: Staffingly offers a range of outsourcing services, including prior authorization, medical coding, virtual receptionists, patient scheduling, medical scribing, and telemedicine support. We tailor our services to meet the specific needs of each client, ensuring seamless integration and optimal support.

Q9: How does Staffingly handle complex cases, such as specialty medication requests or insurance claims requiring extra documentation?
A: For complex cases, Staffingly’s team is trained to proactively communicate with healthcare providers, insurance companies, and ALF centers. We gather all necessary documentation, follow up regularly, and use advanced tools to track each case, ensuring efficient and timely resolutions.

Q10: How can I get started with Staffingly’s services or schedule a consultation?
A: To explore how Staffingly can support your organization, simply reach out via our website or contact us by email or phone. We’ll set up an initial consultation to discuss your needs and create a tailored outsourcing solution that aligns with your goals.

Conclusion: A Comprehensive Approach to Healthcare Outsourcing

Through these case studies and our partnership with the LTC pharmacy, it’s clear that Staffingly, Inc. is committed to transforming healthcare support services. From handling intricate claims to ensuring accurate data management, Staffingly empowers healthcare providers to achieve operational efficiency, financial stability, and improved patient outcomes. As the healthcare landscape evolves, outsourcing to specialized partners like Staffingly can provide the edge that facilities need to stay ahead and deliver exceptional care.