Aspen Healthcare
How Aspen Healthcare took its monthly TripleCheck from a full day to under an hour with Acuri.
<1h
The monthly TripleCheck, down from a full day.
~30 hrs / mo
Senior clinical and billing time reclaimed at the facility.
60+
Medicare compliance checks Acuri runs on every claim.
Gina Galang
VP of Clinical Reimbursement, Aspen Healthcare
From day one, I could tell this was a game-changer. Acuri revolutionized our TripleCheck process by automating the third check which is more thorough than the manual process. Gone are the days of manually validating a long list of compliance standards one at a time for each claim and documenting results on printed paper pre-bill forms. With Acuri, our teams feel more confident that they are billing clean claims.
One of the facilities at Aspen Healthcare was the first building in the group to put Acuri in front of its billing. Before, the monthly TripleCheck took the MDS coordinator, the biller, the DON, and a reimbursement lead the better part of a day, going down every Medicare claim against the record by hand. Now Acuri checks the claims before anyone sits down, and the meeting is under an hour.
The facility was the first in the group to run its billing through Acuri. We started by testing the rules against its recent claims and sitting down with the clinical and AR leads, so the checks reflected how the building actually documents instead of a generic default.
The review that used to take a full day now runs in minutes. The team looks at the exceptions Acuri flags and signs off, and the clinical and billing hours that used to go to checking data by hand go back to patient care, to working denials, and to the claims that actually need a person.
When something is wrong, it shows up while the claim is still open and there is time to fix it, so nobody waits for the month-end meeting to find out. On the strength of that first building, Aspen Healthcare is extending Acuri to its other facilities.
That day was the most expensive meeting the building ran, and most of it was going to pass anyway. Its senior clinical and billing people spent the cycle reconciling every claim against the MDS, the therapy logs, the physician certs, and the rest of the record, while the claims that actually cause denials and clawbacks stayed hidden until after submission, once the billing window had closed and the documentation was harder to pull back together, and the clawback landed months later, after the cash was already spent.
Acuri runs 60+ Medicare compliance checks before submission to surface documentation gaps and give the team evidence to review.