Complete compliance assurance for a growing behavioral health organization

In the span of just five years, a behavioral health provider grew from five clinics and 60 providers to more than 50 clinics employing 750 providers across five states.

The VP of Revenue Operations knew that rapid growth comes with increased payer scrutiny: Payers notice when providers are growing, making compliance coverage more important as a business scales. But even with five full-time coders, the RCM team was only able to get to 10% coverage on manual chart review for payer compliance. The team knew that compliance risks were hiding in the other 90%: Providers sometimes get lax with their documentation after they’ve been with an organization for a while, and newer providers sometimes take time to learn how to fully comply with new standards. 

Getting to 100% review was imperative—but growing the coding and chart review team by 5x was not an option. So the RCM lead turned to Charta for an alternative.

Even as the practice continues to grow and add providers and locations, the RCM team was able to scale compliance review from 10% of encounters to 100% of all charts the business generates—an increase of 90 percentage points.

At the same time that compliance coverage leveled up to 100%, the practice saved on chart review overhead costs and focusing existing staff on exceptions and provider education. Chart review costs reduced by 60% even as review scaled up.