ROI & MRAR Case Study for an Arizona Client
A leading Arizona oncology group, with 15+ locations and thousands of patients,
needed support within its Compliance Department to ensure adherence to healthcare
regulations while responding to audit and legal requests.
What’s Challenges?
- High volume of time-sensitive medical records requests, including Risk
Adjustment Reviews, HEDIS reviews, post-pay audits, and legal responses.
- Staffing limitations, making it difficult to manage both strategic initiatives and
daily demands.
- Lack of a streamlined ROI tracking system, limiting visibility into request status
and volumes.
- Complex documentation and authorization requirements risked noncompliance.
Our Solutions
Lexa Records not only absorbed day-to-day workload butalso redesigned inefficient workflows, enhancingoversight, reducing compliance risk, and freeing internalresources for higher-value initiatives. Lexa Records:
- Provided fully managed Risk Adjustment, HEDIS,claims validation, and post-pay audit requests fromrequest intake through closure, by working directlywith payors
- Managed overflow support servicing approximately5,000 annual legal records requests and enablingcompliance staff to redirect their focus toward audits,training, and strategic process improvements
- Enhanced our secure and proprietary ROI-reportingportal with custom features based on the client’sspecific requests—all at no cost to the client
- Significantly reduced administrative burden on staff
- Improved compliance, turnaround time, and accuracy in audit/legal responses
- Full transparency through advanced reporting tools
