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AVEC Health Solutions: An Incredible Healthcare Growth Story

 John Evensen, Co-Founder & COO And Simon Hughes, Co-Founder & CEO, AVEC Health Solutions For years, AVEC Health Solutions has been driving the success stories of many smaller critical access facilities and rural hospitals. The company realized early on the significance of the rural healthcare market in improving the healthcare outcomes of communities. To this end, AVEC worked toward solving the challenges persistent in these healthcare settings such as lack of coding talent and robust, yet affordable revenue cycle management (RCM) solutions. By delivering big healthcare system efficiencies to the rural market, AVEC has maximized their revenue opportunities as well as improved patient care. Noticing the company's strong record of accomplishments, today, several large healthcare systems are approaching AVEC, seeking services that will help them achieve world-class bottom line results. “All these factors combined have propelled AVEC to witness a record 200 percent growth year-over-year,” extols Simon Hughes, the CEO and co-founder of AVEC. Also, AVEC has grown from 200 to over 800 employees and this year added 100 new FTEs in January alone. “It is indeed a testament to what we are doing is really working,” states John Evensen, co-founder and COO of AVEC.

AVEC has grown organically with its client base that includes both small and large healthcare providers. For one particular client, AVEC was initially contracted to deliver efficiencies across 20 of their locations. Within three years, AVEC now services more than 250 locations for this client. The strategic approach brought to bear by AVEC has played a key role in successfully assisting this client to operate across multiple state borders within the U.S. “We started small and the client realized efficiencies. When they expanded and made acquisitions, we grew with them,” says Hughes.

A Portfolio of Solutions that Drive Client Success

AVEC provides everything from temporary and long-term to complete Coding Solutions covering all account types and reimbursement methodologies. AVEC has teams of experts with vast experience in inpatient, outpatient, clinic, and professional fee coding. They adhere to strict coding compliance and quality standards that result in high-quality, and accurate code assignment. AVEC’s coding solutions are offered per the requirement of the providers, and definitely at the lowest costs when compared to current industry standards.

The company recognizes the fact that solving the issues with claim denials is a time-consuming, multi-step process that includes reassessment, re-coding, and re-submittals of claims. To this end, AVEC offers Coding Audit Services that identify coding errors, under-coding, and over-coding, facilitating the providers to focus on what they do best. “The outcome is a professional coding report that is accurate, meaningful, and actionable,” says Evensen. He continues, “Every coder is required to pass our specific internal assessment before being considered as a potential hire, independent of whatever type of certificate they may hold.

We are the fastest growing healthcare company in our sector

Continuing education is key and all coders must complete ongoing training and exams to maintain proficiencies.”

AVEC also offers robust Revenue Cycle Management (RCM) solutions that cover the full continuum of the revenue cycle from eligibility and authorizations, to coding, billing, denial management, payment posting, and AR follow-up. Furthermore, as providers face the need to change their legacy AR systems as per the healthcare reform mandates, they risk losing millions of dollars during the transition. AVEC solves this challenge by helping organizations transition from legacy systems to their new IT solution without disrupting collection efforts and any data discrepancies during the process. “Cash is the lifeblood of your organization that drives every process. In today's complex healthcare environment we offer everything that helps enhance your cash position,” adds Evensen.

When a client approaches AVEC, the company gathers all needed data from the client's systems and applies data analytics to build customized RCM and Coding solutions that are best suited to the client’s specific need and environment.

Having the Right Ingredients for Growth

“AVEC is the first company to bring Six Sigma successfully to hospital billing cycle and medical coding,” says Hughes. The company applies Six Sigma to track and reduce errors in medical coding to improve the efficiency of billing and AR follow-up. The approach also includes pre-bill auditing of client's claims, which is unique given that most clients submit their claim and hope that it does not hit edits or get denied for various reasons. There is potentially a huge cost associated with resubmission along with the loss of time. The outcome of AVEC’s approach is a significant increase in first-time coding accuracy, efficient claims filing, quicker reimbursements, and lower overall cost. “For the first time, the claims are going out faster, and the money is coming in more rapidly. We are doing two things at once. SixSigma has really differentiated us from the rest.”

AVEC’s skilled workforce equally contributes to the company’s growth. AVEC has local and international teams that serve clients 24/7 worldwide. “Our ability to work in two shifts helps clients see 20 hours of production in a day. This is equivalent to adding almost an extra month to their year of operation,” states Evensen, depending on the client’s environment. He further explains that the client may not achieve the same type of production if they carry out RCM operations on-site. For instance, typically, when a patient is discharged, the hospital starts coding the chart three or four days after. With AVEC, when a patient is discharged, they begin working on the account immediately. “When clients provide us charts in the afternoon, the accounts are completed and back in the system fully coded before the next morning. We can then begin the billing process more timely,” explains Evensen. With such capabilities, the company drastically decreases the discharged-not-final-billed/coded (DNFB/DNFC) and discharged-not-submitted-to-payer (DNSP) files, thus enabling quicker reimbursements.

In case a healthcare provider outsources the complete RCM process to AVEC, it generally considers two approaches.

The client can either completely utilize the AVEC workforce entirely, or, in some cases AVEC provides a hybrid model of AVEC and current hospital staff. In the second model the hospital staff are “rebadged” and become AVEC employees. “Such approaches help optimize staff efficiency, improve performance, reduce overall operating cost, minimize risk, and maintain better control over the whole process,” says Hughes. For example, one of the company’s clients was failing to process the number of accounts daily that was needed in order to maintain cash flow. The local talent pool simply did not have the right knowledge or skill sets. The hospital’s cash on hand had decreased to a point where they only had 10 days’ cash on hand, and the payments were continuously being denied due to coding and billing errors. When AVEC brought in its team and took over the hospital’s entire coding and RCM processes, the hospital’s financial stature improved within two weeks. Today that hospital remains open and is still an AVEC client.

AVEC’s team is well trained and ready to take on any challenge, be it coding or RCM. “We have billers and coders sitting on the bench ready to go. So if anybody needs an emergency department coder, a surgical coder, or a biller, we are able to give them one immediately,” says Hughes. The company also requires continuous in-house training. When AVEC gets a new client, an assessment is made to ensure that the coders and billers match the needs of the client. “Coders have to pass more tests along the way. It is not about them having a proficiency certificate. We continually educate and evaluate them,” explains Evensen. “Our approach and well-trained workforce inspire our existing customers to get us more customers. This is the secret to our growth.”

Going Beyond RCM and Coding Solutions

Besides RCM and Coding solutions, the company builds customized, BI-powered financial dashboards for clients that work with any internal EMR/EHR systems, be it NexGen, Meditech, Cerner, Epic, etc. The dashboards offer C-suites a real-time view of financial data—how it is being leveraged and where—right on their smartphone, tablet, or desktop. “This greatly enhances the client’s capabilities, and provides peace of mind knowing exactly where they stand financially,” says Evensen.

"Our approach and well-trained workforce inspire our existing customers to get us more customers. This is the secret to our growth"

When it comes to security, AVEC has contracted big security firms and they not only design the company’s security and compliance strategies but also conduct unannounced random physical and data security breach testing. They further ensure that AVEC’s and its client’s security are in sync. AVEC carries out at least one external IT hack attempt per year. “We have very rigorous compliance and HIPAA controls. All of our production areas are secured with biometric thumbprints access and personal IDs. Items such as cell phones, thumb drives or anything similar are not allowed inside the production floors,” states Evensen.

Sustaining Growth

“We are the fastest growing healthcare company in our sector,” remarks Hughes. AVEC has been careful to make sure that their operational infrastructure stays ahead of the game. The company has operating facilities in five cities, two in the U.S. and three in India. The company is looking forward to adding two more offshore facilities: one in Latin America and one more in India. “It was our conscious decision to add capacity before we add contracts. This year we want to grow twice in size,” concludes Hughes.