Salem Gastro Discovered $653K Discrepancy

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

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. 

"Healthcare professionals often face challenges balancing quality care with administrative responsibilities," Salem Gastro CEO Andrea Kamenca said.

"Contract management requires significant time investment," Kamenca said. "With our busy schedule, we initially sought external contract management support, but found we needed a more tailored approach."

Kamenca continued, "We needed a solution that could efficiently model our contracts to help us optimize our reimbursement strategies — that's where Rivet came in."

"When our insurance partners proposed rate adjustments, we analyzed them in Rivet and discovered the changes didn't align with our most frequently used service codes."

"Insurance companies provide information about their payment rates, but with Rivet we can access data that helps us understand market rates more clearly."

Now, Kamenca says, "We're able to manage our contract analysis internally because Rivet makes it straightforward to model and understand our agreements."

Kamenca initially thought reimbursement discrepancies weren't an issue at her practice. They have an efficient denial management process and an excellent billing team. 

However, when she analyzed her claims data more thoroughly, she discovered opportunities to improve reimbursement alignment with her practice's contracts.

"You are entitled to receive payment according to the terms outlined in your contract. Having the right tools to verify and analyze reimbursements helps ensure transparency and proper contract management," Kamenca explained.

And for Kamenca, Rivet provides the solution they need.

"We can customize our data views in Rivet and export comprehensive information for documentation purposes whenever needed."

After sharing the data from Rivet with their insurance partner, Kamenca has been pleased with the outcome.

"Rivet provided us with detailed documentation that helped us identify a significant contract interpretation difference worth $653K. The system helped us document and track each provider's portion of the reconciliation."

With improved contract transparency through Rivet, Kamenca now has greater confidence in their reimbursement process.

"Rivet provides the transparency we need to verify our reimbursements align with our contractual agreements. Even when everything is working perfectly, it gives us confidence in our financial operations. As healthcare reimbursement evolves, Rivet helps us maintain accurate financial tracking."

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