Case Study: What A Difference A Year Makes

About AnMed

AnMed is a dynamic, comprehensive health system in Anderson, South Carolina. AnMed provides healthcare for residents of eight counties in upstate South Carolina and northeast Georgia.

Seeking A Safety Net

While AnMed was diligently performing post-discharge coverage discovery early on in the process—scrubbing accounts 3-5 days post-discharge with a vendor in place afterwards—leadership determined that they would benefit from a last effort scrub of all self-pay accounts before moving them to bad debt.

They recognized the possibility of thousands of patients losing coverage as a result of the Medicaid Redetermination and those balances aging in their AR.

Through relationships within HFMA, AnMed learned about Nemadji’s Eligibility Detection solution, an offering that reviews patient accounts for cases of missed eligibility. AnMed brought Nemadji in to perform a final pass at day 90—after their internal processes and existing vendor had already finished their work—prior to accounts being passed to bad debt.

AnMed’s Director of Patient Financial Services and Patient Access, Samantha Evans, explained that when evaluating whether or not Nemadji would be a good fit, “our test file created an ROI that we felt was significant and would be extremely helpful in our self-pay scope of work.”

It was an easy kick-off to the partnership—both the Nemadji and AnMed teams hit the ground running.

“Implementation was very easy on the AnMed team. Our team had very little lift and [the process] works very well with our current EPIC workflow. Nemadji kept us on track for go-live and did most of the heavy lifting.”

More Than Just Self-Pay

The most appealing thing about Nemadji’s solution, according to Evans, is “the technology and ability to find coverage that we (or even other partners) missed. Nemadji helped identify those self-pay dollars and accounts that should in fact, not be self-pay accounts, by providing coverage to be billed and reimbursed.”

AnMed netted $77k in payments within 45 days of implementing Eligibility Detection—with 1/3 of those payments secured on accounts that ranged in age from 10-18 months past the date of service.

“With Nemadji sitting later in the game—at day 90—we really thought there would be a few accounts here and there found. However, we’ve seen a significant rate of self-pay accounts that actually do have billable coverage that we’ve been able to bill and receive payment for. This has been a great addition to our bottom line—that, most likely, is cash we wouldn’t have seen had these accounts moved on to bad debt.”

One year into the relationship, AnMed has added $1.3 million to their bottom line.

“Getting to know the people of Nemadji before actually working with them—the great service, great experience and great results didn’t come as a surprise. Their staff is top notch and are at the top of the industry—and we’ve been thankful for the partnership thus far. We had no doubt they would perform and excel at a high level, and that’s exactly what happened.

When asked what she was most impressed with, Evans pointed out, “hit rate and overall cash improvement from accounts we’ve been able to go back and bill where Nemadji has found coverage. They are also very responsive and provide great customer service to us and our team.”

In addition to an increase in revenue, AnMed has also experienced a decrease in bad debt AR%, an increase in net collection ratio and a decrease in self-pay days in AR—3.8 down from 4.1.

Last Words from Samantha

“Nemadji continues to be a great partner for AnMed.

It’s not about them offering a product, but it’s a true partnership. We bring up certain things as potential possibilities for enhancements, and they take it back to their team to create it. They have gone above and beyond from the very beginning. From implementation to the monthly invoice and status calls, they are always very responsive and proactive in our relationship.

We will continue to build and grow in our relationship with Nemadji—whether that means moving them further up in the cycle or leaving them where they are now for optimal efficiency. We also continue to learn from the accounts that Nemadji does find, to then turn around and educate our staff on anything we could have done differently from the beginning.

So, whereas Nemadji serves to catch the things we don’t, we also utilize their reporting and “catches” to implement more training up front.

AnMed has had a great experience with Nemadji so far, and we’re excited to see where this partnership takes us.”

Further Reading

June 25, 2021

Working With Nemadji | Part 5: Finding Revenue That Others Are Not

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March 24, 2021

Working With Nemadji | Part 3: Lost Cash

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January 20, 2021

Working With Nemadji | Part 1: Nimble and Driven to Provide Value

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