Real-time auditing, error detection and alerts helped SEALS recover $4.8m in debt in 21 months


About South Eastern Laboratory Services (SEALS)

SEALS is a part of NSW Health Pathology, delivering laboratory medicine services to all public hospitals serviced by the South Eastern Sydney Local Health District and the Illawarra Shoalhaven Local Health District. SEALS also provides a comprehensive referral service to other hospitals, laboratories and community-based Medical Practitioners.

SEALS is focused on delivering comprehensive, high quality diagnostic and clinical services to state, national and international reference laboratories and has a strong reputation for working collaboratively with clinicians and other institutions to foster relevant research and best practice diagnosis.

The challenge

With outstanding debtors of over $7.1 million, SEALS established a revenue team in April 2014 to address this issue by focusing solely on billing and debt recovery.

Whilst the team was very focused and hardworking, most were inexperienced with large-scale billing and debt recovery. While there was an existing billing software system in place, it was limited in its capability and complex for the debt recovery team to use.

The limitations of the system, the volume of debtors, the inexperience of the team, combined with the time being spent on printing invoices, fixing numerous errors, and then reprinting invoices prior to despatching the team were unable to reduce the outstanding debtors.

Beamtree solution

SEALS leveraged Beamtrees’ RippleDown Auditor solution to automate the identification and resolution of errors in real-time. The RippleDown solution was able to integrate with SEALS’ existing LIS which enabled information to be quickly captured and analysed from multiple sources and then reported to the relevant administrative staff for action.

With real-time flagging and reporting, RippleDown was able to generate alerts for billing and insurance eligibility. This meant that hospitals and collection centres could be immediately notified of patient billings, outstanding invoices, or missing information, at the time the patient presented themselves. This capability had an immediate and significant impact on the outstanding debtors.

RippleDown also enabled the team to identify and fix a variety of errors in the post-invoice generation process. Furthermore, with all actions and cases being audited in real-time, management was able to quickly and easily identify where mistakes were being made. According to management, this enabled the accuracy of the team increased significantly.

All these strategies deployed over a period of 21 months has reduced our debt to $2.3 million (from $7.1 million). Besides tremendous team work, I credit our success to Rippledown. I really consider Rippledown as our saviour.”
Nutan Sharma, SEALS Network Revenue Manager


RippleDown Auditor has enabled SEALS to reduce their outstanding debtors from $7.1 million to $2.3 million – a reduction of $4.8 million – in just 21 months.

By leveraging RippleDown to correct errors in real-time– ensuring invoices are submitted accurately, invoices are now being paid more promptly. This has enabled the team’s time to be focused on genuine overdue accounts as opposed to unnecessary reminder notices, and facilitate regular follow-ups which in turn has led to regular payments. This has directly influenced the productivity of the entire team.

Specifically, RippleDown Auditor enabled SEALS to:

Accurately generate invoices
SEALS existing billing system was not capturing health member numbers or private patient information, so the majority of invoices (500 out of 700 in one week) were being generated with missing information. RippleDown enabled the billing team to receive real-time alerts of these episodes so the team could enter the necessary membership details prior to invoice generation. This meant that all information was captured correctly and invoices could be submitted promptly and payment could be made within the 30-day payment terms. This significantly impacted the reduction of debt and also reduced printing and postage costs.

Capture new born baby billing issues
RippleDown was able to change the debtor details for newborn babies – who are not registered with Medicare or a private health fund – to the mother’s name to enable invoices to be produced and paid in a timely manner.

Review accuracy of patient’s address
A significant portion of invoices were being sent to the wrong address due to an issue with the existing billing system which would automatically default to a NSW postcode if the postcode had not been entered. In one instance – 98% of returned mail invoices had been incorrectly addressed to a NSW postcode. By leveraging RippleDown to capture all medical record numbers and flagging those that had an interstate location code, SEALS were able to immediately correct any errors and send the invoice to the correct address. As a result, SEALS have seen a majority of previously misaddressed invoices paid within days of despatch.

Medicare eligibility
SEALS have created rules within RippleDown to automatically identify Medicare ineligible patients. The system is able to capture this category of patient while they are still an inpatient – which has led to a dramatic improvement in debt collection for a group who would often elude the debt recovery team upon completion of treatment.