Driving RCM Efficiency with Technology and Human Expertise

About Acadia

Acadia Healthcare is one of the nation’s largest behavioral health providers. With more than 75,000 patients and 175 locations across 33 states, the Acadia Comprehensive Treatment Centers (CTC) Division offers a full continuum of care for individuals and families. Their network specializes in treating behavioral health and substance use disorders, including comprehensive medication-assisted treatment (MAT) programs. 

The Need for Revenue Cycle Transformation

For an organization as vast and innovative as Acadia, reliance on legacy revenue cycle processes created some challenges. Manual workflows meant revenue cycle teams were chasing information across systems. Additionally, the denials management process lacked real-time visibility, and eligibility efforts were duplicative.

Sound familiar?

To get in front of these challenges that burden many human services organizations, leadership at Acadia knew they needed to collaborate with someone that not only understood revenue cycle but also had deep expertise in behavioral health and addictions treatment. They recognized Netsmart as that ally.

Automation + Technology to Optimize Collections, Eligibility and Prior Authorization Workflows

Acadia’s first priority was to replace inefficient processes with automation. The collections workflow was a great place to start. With AlphaCollector, information that previously had to be pulled separately from 175 clinics is now centralized.

“We have 175 clinics that we need to get information on and work,” explained Kimberly Copp, Acadia’s Director of Business Office Operations. “Consolidating that information into one place has been the biggest impact for us. Just having all the information and denials in one place in near-real time has made a huge difference in the organization and productivity of our team.”

As many behavioral health and addictions treatment organizations can relate to, eligibility-driven denials were a major pain point. Previously, staff had to dig through multiple portals to resolve issues. “With AlphaCollector, denials surface in a single location, allowing them to be addressed quickly,” Copp added. 

By pairing AlphaCollector with RevConnect clearinghouse, Acadia modernized collections and denials management workflows, with an emphasis on optimizing eligibility and prior authorization processes. Copp noted, “We have 75,000 patients, so that’s a lot of manual checking. Before RevConnect clearinghouse, staff would go directly into payer portals for monthly eligibility checks. We didn’t have batch eligibility before. Now with RevConnect clearinghouse, we can submit eligibility for all payers through a flat file, which is huge for us."

RevConnect also helped Acadia mitigate prior authorization denials. “We can put rules in to hold claims that don’t have authorizations, so they’re flagged. That way we get the authorization before sending them,” said Copp.

“Between RevConnect clearinghouse and AlphaCollector, denials management is so much easier.”

- Kimberly Copp, Director of Business Office Operations, Acadia Healthcare

Tools that Go Beyond Efficiency

The RCM benefits didn’t stop with streamlined workflows. With AlphaCollector, Acadia gained visibility into staff productivity and denial trends.

“I like to look at denials because I can drill down and compare month-to-month at the organizational or regional level. I can see which denials are spiking or reducing, which we couldn’t do before. I use that a lot,” Copp said.

Analytics and reporting within RevConnect provided similar advantages on the clearinghouse side.

With more than 350,000 claims submitted each month, Acadia’s teams needed more than just transaction visibility—they needed intelligent grouping, queuing and search. “We bill over 350,000 claims a month, so having the ability to search based on criteria in both RevConnect and AlphaCollector is huge for us. We just haven’t had that ability in the past,” Copp explained.

Expert Services to Solve Complex Billing Challenges

Even with powerful technology in place, some challenges require specialized expertise. Acadia chose to partner with the Netsmart RCM services team to address one of their most complex areas: billing in California.

"Working with the RCM services team has been really impactful. Our systems were cumbersome and manual, especially in California, and their ability to organize and automate has been huge. They find trends very quickly and communicate that information with us. I really like working with that team—it’s been a good partnership,” Copp said.

"Being able to better automate California billing and having the RCM services team keep it organized has been huge. They find trends very quickly and communicate well with us.”

- Kimberly Copp, Director of Business Office Operations, Acadia Healthcare

Results and Impact

Through the combination of AlphaCollector, RevConnect and RCM services, Acadia is transforming its revenue cycle management. Workflows that once consumed hours of staff time now happen with clicks. Eligibility and prior authorizations are handled more proactively. Denials management is shifting from reactive to preventive. And with expert services available to tackle complex issues, Acadia’s revenue cycle leaders can focus on strategy rather than firefighting.