Introduction

Benji Rostoker, COO, and Co-Founder of FlexTogether, established the virtual pulmonary rehabilitation clinic to address the limited access faced by the 53 million chronic lung disease patients.

FlexTogether aims to bridge this gap by offering synchronous telehealth visits with respiratory-trained physical, occupational, and speech therapists, partnering with physician groups and health systems to enhance quality of life and reduce healthcare expenses.

FlexTogether is at the forefront of virtual pulmonary rehabilitation, delivering impactful outcomes through its telehealth program. With a focus on serving the estimated 53 million eligible patients, FlexTogether collaborates with healthcare professionals to achieve the industry’s potential for a projected 62% reduction in mortality, 3x reduction in readmissions, and estimated average of $32,000 savings per patient.

The clinics, already established in CA, FL, and VT, plan to expand to TN. As a member of the Cedars-Sinai Accelerator and Project Healthcare in Nashville, FlexTogether is positioned to revolutionize the approach to chronic lung disease care.

Challenges

Before integrating Oystehr into their operations, FlexTogether faced significant challenges in the billing process. The manual and time-consuming nature of the process demanded substantial human resources allocation.

Claims experienced delays of weeks before submission, with the added burden of manual data entry. These inefficiencies were hindering the overall effectiveness of the clinic's operations.

After Oystehr

The team at Oystehr played a pivotal role in streamlining FlexTogether's clinic note to claims submission processes. As a developer-first platform, Oystehr seamlessly balanced the custom user experience of FlexTogether with the efficiency of standard clearinghouse requirements. The claims submission integration allowed FlexTogether to complete a clinic note and submit a claim within minutes, significantly improving Days Sales Outstanding (DSO) metrics and increasing working capital.

By reducing the dedication of resources toward the claim submission process, FlexTogether can now redirect attention and capital to acquiring more patients and enhancing the quality of care provided. This newfound operational efficiency positions FlexTogether to further expand its reach and impact within the virtual pulmonary rehabilitation landscape.

The revenue cycle management upgrade

To tackle the issue of managing revenue cycles efficiently, FlexTogether utilizes Oystehr's FHIR datastore and APIs. This tailor-made solution streamlines the transmission of claim data, facilitating real-time management of payments and denials. The advanced datastores and mapping capabilities of Oystehr align claims data extracted from EHRs with FHIR-compliant formats, ensuring seamless integration with CMS 1500 billing forms.

Automation is a central component of the revenue cycle management (RCM) solution, with Oystehr's Zambda Functions taking charge of tasks such as data ingestion, normalization, export, and handling claim status requests. Despite its developer-driven nature, Oystehr also offers user-friendly interfaces, empowering practices to efficiently monitor claim statuses.

How can your practice benefit?

In the realm of healthcare practices, billing stands as the vital force that sustains operations. The challenge often lies in finding Revenue Cycle Management (RCM) solutions that are both effective and tailored to the unique needs of the practice, especially for smaller entities. Oystehr presents a distinctive approach with its API connectivity, robust data storage, and programmable flexibility, offering a fully customized solution for your practice's specific billing requirements. As a FHIR-compliant and ONC-Certified* health tech platform, Oystehr is designed to address the complexities of modern healthcare seamlessly.

Oystehr's capabilities go beyond the conventional, providing automation for routine practice tasks that typically demand laborious manual processing, such as claims filing. This ensures not only efficiency but also frees up resources for more critical aspects of patient care.

Conclusion

“Oystehr is a highly efficient, developer-first, and cost-effective solution for medical record storage and claims management”, says Benji.

The successful collaboration has not only addressed the challenges faced by FlexTogether but has also contributed to the overall efficiency and effectiveness of their operations.

This partnership highlights the transformative impact of combining innovative health tech solutions to bring about positive change in patient care and clinic management.