Insights into revenue cycle management

Case Study: How a multi-state ABA provider increased its first pass paid rate by 15%

“We were bleeding and we didn’t even know it. You guys knew what we were talking about, and how to help us out in the way we needed you to. It was a partnership from the beginning - I’m all about that. When we met you guys, we knew there was going to be support.” 

– Tammy Pedersen, Senior Director of Managed Care and Billing at Intercare

Multi-state ABA provider Intercare partnered with Juniper to increase its first pass paid rate by 15% and reduce initial denials rate by more than 80%.

Established in 1970 by a speech pathologist who went on to focus on pediatric autism services, Intercare is a family-run, family-focused ABA provider that serves hundreds of families with clinics operating in California and Colorado.

The Intercare team had previously worked with their EHR’s managed billing vendor for several years. This seemed to be the most straightforward option then, given the billing group’s organizational ties to the rest of their clinical tools. But over time, the team realized that the inconsistent customer support, high account management turnover, and lack of transparent reporting left them with slow and incomplete insurance reimbursement.

Intercare decided to turn to a more advanced, technology-based solution. They wanted to not just resolve existing revenue cycle issues, but also touse automation to prevent future issues with consistency and transparency. Intercare sought a true partner that would reinforce best practices and build a more optimal revenue cycle function. 

In early 2022, Intercare partnered with Juniper, a technology company that provides automated insurance billing for ABA, SLP & OT providers. Their partnership has greatly boosted Intercare’s bottom-line metrics, optimized team efficiency, and strengthened cross-functional collaboration throughout their revenue cycle function. 

Higher trust and visibility into claims data 

Intercare’s previous billing workflow used unstructured billing labels and manual Excel spreadsheets in an attempt to account for held or denied claims. The lack of cohesion made it difficult to understand what actions to take and when, leading to unidentified and unresolved problems that would cascade into more significant issues.

With Juniper’s claims and task dashboards that update daily, Intercare gained the visibility into their own data that they needed to operate effectively and efficiently across dozens of insurance payer claims. 

The team now uses Juniper tasks to understand each specific action they need to take to resolve would-be denials, before they even happen. Each task is generated by smart, payor-specific billing rules that do much more than simply scrub for basic errors — they proactively prevent denials according to an engine trained on millions of other claims.

Tasks are also highly collaborative, with flexible assignment and open communication threads between teammates. Direct integration with their EHR connects each task to its respective session to triage and resolve the issue quickly, then enables Juniper’s system to re-ingest the sessions for resubmission automatically once ready.

Having proactive, prescriptive issue resolution that prevents denials goes a long way to helping the Intercare team focus on the highest priority items and address future issues before they arise.

Tammy Pedersen, the Senior Director of Managed Care and Billing at Intercare, can attest to this being “the biggest reason” and the one of the “best parts” about partnering with Juniper. “There were just limited ways to track everything before,” she explains. “Now I can see the full picture, stay on top of it, and know what’s going on at any point.” 

The impact is clear: Intercare’s first pass paid rate has increased by 15% since collaborating with Juniper.

Having Juniper’s task system be both user-friendly and easy-to-train has also been empowering for the Intercare team. "Making things so much more user-friendly has been huge,” Tammy continues. “I can trust that my team can figure out the platform, which wasn’t the case before. I know I don’t have to be so in the weeds for things to run.”

Stronger communication systems and support 

Before, Intercare’s team would see cash flow issues and then start asking questions to their billing vendor. But it often seemed as though every answer would only raise more questions. Intercare’s team would spend significant time and energy to help their vendor understand the root causes behind the cash issues, causing frustration with constant back-and-forths to find a resolution.

Switching to Juniper made a stark contrast. Tammy found that Juniper would be a team they could rely on, explaining that “it was a partnership from the beginning — and I’m all about that. When we met you guys, we felt like there was going to be support.” 

Much of the support came from a combination of the technology and case-specific subject matter knowledge. While the automation was an invaluable asset for preventing denials proactively and processing claims seamlessly, having a close partner  to communicate the higher-level, big-picture trends and escalate high-priority, specific tasks proved to be just as important. 

Intercare’s client families have also been affected positively. Before, parents or caretakers would call in with questions that Tammy’s team had to take the time to research every answer themselves. Juniper’s communication and data visibility has helped greatly. “We used to have to field our patient families’ questions,” Tammy says.  “Now, it feels a lot better because we actually have the answers.”

Fewer hours spent on billing 

The Intercare team also manages several other priorities besides just billing and collections across the full spectrum of managed care. Prior to Juniper, Tammy felt they were dedicating too much time to billing and less to other priorities that still needed attention. 

She explains: “At one point billing took up 60% of my time, amongst all the other responsibilities on my plate as director of managed care.” 

Since bringing Juniper on board, Tammy and the rest of her team has been able to free up their time for more important priorities. Instead of having every billing-related issue on her plate to then try to delegate appropriately, the Juniper task system easily routes different types of action items through the organization and gives her the peace of mind that open issues are being resolved effectively.

“Just having the tool to be able to easily work claims cuts the work in half. We know what the problem is, and how to solve it. We used to put a lot of legwork into figuring out why claims were getting denied before we even got to figure out how to solve it.”

She adds, “It’s nice to have [billing] go back to a more reasonable amount. This frees up my time for the several other things on my plate.”

What’s next for Intercare 

Over the course of their partnership with Juniper, Intercare has continued to see the rate of new product development and continued improvement, especially as their own needs change over time. Tammy and her team continue to meet with the Juniper team frequently to review both detailed, specific cases and high-level strategic insights.

“You’re adaptable to what we need — as big picture or as granular as can be. I really appreciate how Juniper helps us out.”

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