81% → 96%
Visits paid at full rate · Community health centers
The patient who qualified
Every patient who qualifies for coverage should have it, and every visit should be paid at your full rate.
A composite, built from health centers like yours. Not a named client.
- The problem, $1.2M a year, Visits paid at $20, not $190
- The project, SBK rebuilds registration, scheduling, billing and reporting so coverage is caught and every visit is paid in full.
- The outcome, 96%, Visits paid at full rate
A mother of two checks in for her daughter's visit. She pays $20 on the sliding fee. She has qualified for coverage for a year. Coverage would have paid the center $190 for the same visit. Nobody asked.
Picture a community health center with five sites, 15,000 patients and a waiting room that is always full. Coverage was checked once a year, on paper, at the front desk. 42% of patients had none, and many of them qualified. Schedulers juggled the phones while 90 slots a week went empty. Coders keyed claims from notes days later, and one visit in five was paid below the center's full rate. Every year, the grant report took six weeks of staff time to build by hand.
What SBK rebuilt
SBK mapped the path from the front door to a fully paid visit and on to the grant report. Missed coverage cost the most. It was about $1.2M a year in visits paid at $20 that coverage would have paid at $190. The rebuild checks coverage at every visit. When a patient qualifies, a navigator enrolls them the same day. Reminders and a live waitlist fill canceled slots. Each claim is checked against the full rate before it leaves. The grant report now builds itself from the records clinicians already keep.
What moved
Patients with coverage rose from 58% to 74%. Visits paid at the full rate went from 81% to 96%. Empty slots fell from 90 a week to 30. The grant report took one week instead of six. The center saw more patients and was paid properly for each one.
| Measure | Before | After |
|---|---|---|
| Patients with coverage | 58% | 74% |
| Visits paid at full rate | 81% | 96% |
| Empty slots a week | 90 | 30 |
| Weeks on the grant report | 6 | 1 |
A problem like this one?
David from SBK replies within one working day.