Case Studies

Towner County Medical Center Increases Cash by Over 30% in First Year of Insource

Insourcing partnership increases cash from the prior fiscal year, reduces billing and follow up errors, increases compliance and up front collections; providing the benefits of outsourcing without eliminating staff or taking processes offsite.

Towner County Medical Center (TCMC) is located in Cando, North Dakota. The city was named for the original pioneers’ “can do” spirit and the community has long continued the tradition. Towner County Memorial Hospital was founded in 1953 and was paid for entirely by the community and the order of the Sisters of St. Francis.  In 1992 TCMC was purchased by the County, becoming Towner County Medical Center. TCMC is a 57-bed facility offering inpatient and outpatient services, 24-hour emergency room, lab and radiology, surgery and nursing care to ensure patients are assessed and treated quickly. TCMC is dedicated to excellence in patient care providing the highest quality healthcare at an affordable cost to the residents of Towner County and the people of North Dakota.

Ensuring Community Services
Like many rural and community providers across America, TCMC faced serious financial impact from revenue cycle operational issues. Executive leadership recognized that, despite the current business office support being received, claims transmission, billing and follow up issues, a lack of up front collections, inadequate compliance training, and coding concerns were all directly impacting cash flow. Seeking a meaningful long term solution to quickly improve revenue cycle efficiency, executive leadership reviewed the options. They determined partnering with re|solution under an insource arrangement would best support these goals.


Making a Smooth Transition
TCMC’s leadership collaborated with re|solution using an Engagement Management Action Plan for an efficient insource transition. The plan outlined a variety of milestones and goals designed to optimize revenue cycle operations. TCMC employees were transitioned to re|solution, retaining jobs in the community.

Ivan Mitchell – CEO for TCMC said, “We immediately knew the decision to work with re|solution was the solution we had been looking for. Their expertise of the revenue cycle allowed them to not only mentor and train our staff quickly and efficiently, they were able to provide the support needed making our staff feel valued during the process. Together we created the framework for a cost effective approach to a revenue cycle focused business office. We had no idea how quickly things would turn around when revenue cycle operations were streamlined or how substantial the cash increase would be.”



Productivity initiatives and a comprehensive training program create a solid foundation for future performance
While the typical outsource removes jobs from the community and does nothing to reduce expenditures or improve current vendor performance, re|store™ insourcing eliminates these dilemmas. re|solution assumed responsibility for all day to day operations and the Business Office Manager immediately began implementation of the Management Action Plan. A monthly meeting was scheduled with Executive leadership to collaborate on improvements and progress. The experienced re|solution business office manager was placed onsite to train and mentor the current staff and also took responsibility for managing all additional resources necessary to assist in rapidly improving cash flow.

Highlights of the Engagement Management Action Plan included:

  • Daily transmission and follow up of electronic claims
  • Reduction and stabilization of DNFB
  • Engagement of an early out vendor resulting in an increase of patient responsibility dollars
  • Charge Capture Review
  • Training of clinic nurses, lab and radiology personnel on proper documentation


Guaranteed Performance – Peace of Mind
re|solution provided additional staff upon transition to ensure revenue cycle improvements proceeded quickly. The business office staff and registration staff were trained on insurance verification and up front collections.  Clinic nurses, lab and radiology personnel received comprehensive training on proper completion of ABNs. Issues with daily claims transmissions, billing and follow up were resolved. The business office staff immediately completed compliance training and testing which reduced billing errors by utilizing best practices.

In the first year Towner County Medical Center saw an increase in cash of over $1,600,000. Hospital insurance accounts over 90 days improved to 44 days. Clinic insurance accounts over 90 days are at an all-time low of 25%. Gross days in AR for both hospital and clinic are 59 days from a high of over 100 days. The engagement continues to focus on keeping and moving all key performance indicators to best practice levels.


White Paper

Click here to download  2014-Insourcing White Paper

Copyright 2014 re|solution - All Rights Reserved.