3 Enrollment Mini-Case Studies: How Consultation Improved Efficiency for Healthcare Clients

With the role of locum tenens providers (often at the center of enrollment misconceptions) evolving into a strategic workforce solution, the need for streamlined provider enrollment is more urgent than ever to control operational costs that affect the bottom line. Where use of the Q6 modifier was once the norm for temporary providers standing in for others, longer assignments and other factors have eroded its relevance as time goes on and organizations use contingent labor as a strategic solution.

It’s time to fundamentally rethink how the industry perceives and approaches provider enrollment. What began as a growing need that we saw from healthcare clients—both large and small—is now an innovative, full-service consultation and outsourcing offering unlike any other. This approach eliminates inefficiencies, prevents revenue loss, and enables billing departments to get their heads above water, setting a new standard in healthcare management. Here is the story of why we came to this realization and service offering.

Early Warnings: Recognizing the Need and Capacity

In 2021, a private practice in Virginia reached out to LocumTenens.com for help. The practice was run by a single MD, who needed to take a leave of absence for surgery, and so they turned to LocumTenens.com to bolster their provider staff. Complications with the MD’s surgery necessitated an extended medical leave. In addition to this, the practice was onboarding a physician assistant, which disqualified use of the Q6 modifier.

A single office manager took on all billing and enrollment duties and quickly became overwhelmed. Unfamiliar with the process, this led to errors and delays, with insurance applications sent to the wrong states.

We stepped in, going above and beyond what was expected for a staffing company at the time. Leveraging the expertise of LocumTenens.com’s experienced associates, we pre-filled the applications, guided her on where and how to submit them, and completed the rosters for the practice.

Later, the MD credited this service with keeping his practice in business while he was recovering and unable to work. The necessity for increased support—a more consultative solution—was becoming clear.

Modern Challenges: Expanding Our Proactive Approach

The response to our proactive approach continues to demonstrate the urgency of this market need. Let’s take a look at two current hospital clients who reached out for enhanced enrollment assistance:

• A community health center with three facilities in Oklahoma had never used locum tenens before, and was unsure whether the solution was affordable with their size and resources. With only one person handling all enrollment tasks, this facility was more than happy to receive assistance filling out applications. This partnership also led to two additional provider bookings, including two advanced practice providers (APPs) and one physician, with plans for a third. Ultimately, our team’s effort to proactively complete all enrollment applications for the health center saved three full days of work, letting them move forward with operations.
  
  
• Similarly, a smaller Ohio hospital health system that regularly used locums reached out for help with commercial payors. They had a working understanding of Medicare/Medicaid applications but found commercial payors a significant challenge. The health system was astonished by the level of service we provided in this new area of consultation—even stating they had never seen such support before from other locum tenens agencies.

As these conversations with clients reveal, such challenges are not confined to smaller-scale health systems. Provider enrollment proves a common pain point from small community health centers to major national health systems.

Looking Ahead: Preventing Disarray and Lost Revenue

One healthcare client in the early discussion stage shows the continued need enrollment consultation and outsourcing—as well as the extent. This west coast-based healthcare network with more than 200 locations, including acute care hospitals and clinics, found themselves in a situation where the billing and enrollment department was in significant disarray. Due to operational challenges, nearly 20 clinicians have fallen through the cracks and gone un-billed for, resulting in millions of dollars of lost revenue. Our team is poised to step in, streamline their processes, recover these lost funds, and prevent future oversights like these.

What Is Unique About Our Approach to Enrollment Services?

Outsourcing enrollment tasks often leads to confusion and high costs, as external companies often ask numerous questions without necessarily providing clear solutions. Our team:

• Takes on the workload enrollment professionals whose backlog is insurmountable.
• Offers expert advice and consultation to streamline enrollment practices.
• Enhances the overall process, reducing financial losses.

Our dedicated team of experts from a variety of backgrounds ensures speed and accuracy. Unlike many outsourcing options, we embed speed into the process, a critical added benefit for both small and large organizations alike.

Next Steps: Thinking Differently To Beat Backlogs

The healthcare industry struggles against billing and enrollment woes. To increase efficiency and push back against widespread administrative burden, a top contributor to burnout, our effort redefines who should be involved in the enrollment process from start to finish to end the rampant efficiency challenges in this area. Our innovative solution is built from the ground up to address the backlogs and errors of all kinds with a true partnership. We are committed to transforming the enrollment landscape for healthcare providers.

If your organization is facing challenges with provider enrollment, contact us below to see how our proactive, expert-driven approach can make a difference for your practice.