Salem Gastro Loves Their 'Insurance Watchdog'

“Rivet is worth it. Even if you find nothing and everything is perfect, you have the confidence that everything is actually perfect with Rivet. 

“Insurance companies change rules on a regular basis, but Rivet is the insurance watchdog that keeps us paid what is deserved.”

As of 2024, CEO Andrea Kamenca led Salem Gastro to a 25% profitability increase in 2023, and led Salem Endo to 50% profitability increase in 2022 and 34% in 2023. Andrea and her team have used Rivet since 2023. The following is Andrea’s experience using Rivet to uplevel revenue cycle processes. 

“Doctors routinely say: We're working hard and getting paid less,” Salem Gastro CEO Andrea Kamenca said. 

“Contract negotiations are their own can of worms,” Kamenca said. “There isn’t enough time in the day to do everything, so it was important to bring on additional negotiation consulting and it was a rather terrible experience.” 

Kamenca continued, “We needed a solution that modeled out our contracts for us so we could get the most advantageous contracts — fast. That’s where Rivet came in.”

“When insurance said they were raising some of our rates, we modeled it in Rivet and quickly determined that we didn’t use the codes they were raising. It wasn’t helpful at all.

“Insurance will always tell us that they are paying us at the highest they pay anyone, but with Rivet we can prove that they can pay us more.”

Now, Kamenca says, “We don’t need consulting for our contracts anymore because it is so easy to manage and model contracts in Rivet.”

Kamenca initially thought that underpayments weren’t an issue at her practice. They have a low denial rate and a killer billing team, after all. But when she dove deeper into her claims, it became clear that insurance payers had been shorting her practice. 

“You are only guaranteed up to the amount promised in your contract. And though it doesn’t seem right for fair, there is no real surety of full payment without the right solution to keep payers accountable,” Kamenca explained.

And for Kamenca, Rivet is the solution for the job. 

“We can determine what columns are important and how to display the information in Rivet. Then, we can download the spreadsheet for insurance any time.”

After downloading the data from Rivet and sending it to insurance, Kamenca has been thrilled with the result.

“Rivet gave us the proof needed to show the insurance company that they had coded our contracts incorrectly to the tune of $653K. Rivet helped each of our providers get the portion they were owed instead of paying out $653K in a lump sum. "

Even though she has a lot less underpayments thanks to Rivet, she said Rivet continues to give her the peace of mind that Salem Gastro is steadily being paid correctly.

“Rivet is worth it. Even if you find nothing and everything is perfect, you have the confidence that everything is actually perfect with Rivet. Insurance companies change rules on a regular basis, but Rivet is the insurance watchdog that keeps us paid what is deserved.”

Learn more about Rivet's robust underpayment and payer performance tool now: Schedule a Rivet demo