Case Study: Primary Care Centers of Eastern Kentucky achieves accurate, timely Medicaid reconciliation with eClinicalWorks

Primary Care Centers of Eastern Kentucky - Customer Case Study

Primary Care Centers of Eastern Kentucky (PCCEK), a multi-specialty practice with 31 providers across four clinics, faced a huge administrative burden when Kentucky Medicaid required reconciliation of every line-item transaction from multiple managed care payers against Medicaid balance payments over a three-year period. The volume of data, constantly changing payer rules, and limitations of spreadsheet tools created a high-risk situation with potential multi-million-dollar recoupment exposure.

eClinicalWorks HBI built custom eBO reports to reconcile every claim line, payment, ICN, provider encounter, and Medicare-secondary detail across the three-year period. The tailored reports delivered accurate, timely reconciliations, allowed PCCEK to document and prove every transaction during state reviews, prevented significant financial recoupment, and ensured appropriate compensation and operational peace of mind.

Primary Care Centers of Eastern Kentucky

Sheila Bowling

Billing Manager