Press Releases

St. Vincent Health Selects ARx for Extended Revenue Cycle Services

FRANKLIN, Tenn. – St.Vincent Health is expanding its long-term relationship with ARx, adding extended revenue cycle management services to more of its facilities to help increase cash flow and improve margins. ARx will assist in the management of billing, revenue recovery and accounts receivables collections.

ARx will also be assisting St. Vincent in the migration of two of its hospitals into the organization’s central business office (CBO) operations center. The two newest hospitals are St. Vincent Salem Hospital, a 25-bed facility in Salem, Ind., and St. Joseph’s Hospital, a 186-bed facility in Kokomo, Ind. ARx will guide the hospitals through the implementation of proven, best practice processes for sustainable financial and operational improvement as part of the third-party billing and collections services ARx will be providing.

For more than nine years St. Vincent has utilized ARx for a wide variety of business office operations support. The successful relationship began in 2003 when St. Vincent acquired Women’s Hospital in Indianapolis from Hospital Corporation of America (HCA). St. Vincent needed an outside firm to provide full business office services until the hospital could be managed from its internal CBO. Within five days of the initial transaction, ARx was producing accurate and clean bills for the facility and continued with full business office operations responsibility for two years until the seamless migration to the St. Vincent CBO was completed in 2005.

“ARx has been instrumental in our transition to an internal CBO and has provided us with efficient, outstanding results since day one,” said St. Vincent Health System Director of Revenue Cycle Phil Skinner. “We are looking forward to growing our relationship further and the exceptional services they will provide in relation to our billing and accounts receivable needs.”

“This successful partnership we have formed with St. Vincent Health is a direct reflection of the strength of ARx’s commitment to support the healthcare organizations’ operations and deliver measurable financial improvement,” said ARx Chief Financial Officer Bill Chace. “We have the services needed to assist providers across the country who are proactively addressing operational efficiency through their revenue cycle strategies. Our collaborative approach will help St. Vincent fine tune its revenue cycle and provide targeted solutions to help the organization achieve its financial goals.”

About St.Vincent Health

St. Vincent Health is a nonprofit, spiritually-centered health system, sponsored by Ascension Health of St. Louis, MO., the nation’s largest Catholic health system. St.Vincent Health is one of Indiana’s largest employers with 20 health ministries serving 47 counties in central Indiana. The 130-year-old health system delivers high quality, compassionate care in service areas such as cardiovascular, women’s, children’s, neurosciences, cancer care, orthopedics, bariatrics, primary care, emergency medicine, imaging, general surgery and long-term acute care. For more information, visit

About ARx

Since 1997 hospitals across the country have relied upon Franklin-TN-based ARx, LLC as a trusted and dependable extension of their business office operations. The Business Office Services provided by ARx enables hospitals to optimize their billing and account follow up efforts, without having to add staff or additional overhead. By leveraging the existing infrastructure and business office expertise of the ARx organization, healthcare service providers can more quickly and economically achieve their organizations’ revenue cycle management goals. For more, visit


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Healthcare Industry Contributes $30 Billion to Nashville Economy

nashville health care council

Health Care is Largest and Fastest Growing Local Employer  

NASHVILLE – Nashville’s health care industry contributes nearly $30 billion and 210,000 jobs to the local economy, according to an economic impact study released today by the Nashville Health Care Council. The industry also has a far global reach, with 56 health care company headquarters* that generate nearly 400,000 jobs and more than $62 billion in revenues worldwide. 

“The health care industry is Nashville’s largest and fastest growing employer,” said Nashville Mayor Karl Dean. “Beyond health care providers, Nashville is home to a diverse sector of leading health care companies not found anywhere else, including hospital management, health information technology, disease management and more.” 

More than 250 health care companies have operations in Nashville, an industry concentration that ranks it above 13 other similar cities including Atlanta, Birmingham, Dallas, Denver, Indianapolis and Louisville based on the number of health care companies, industry revenues and employment. 

“Nashville’s health care industry has a major economic impact not just at the local level, but nationwide and across the world as illustrated in this study,” said Joey Jacobs, current chairman of the Nashville Health Care Council and chairman, president and CEO of Psychiatric Solutions, Inc. “With findings of this magnitude, it is easy to understand why Nashville is often referred to as the health care capital of the U.S.” 

Nashville’s health care employment growth has outpaced Tennessee and the nation, creating a vibrant industry hub, with one in eight Nashville workers employed by health care providers. In Tennessee, clinical occupations are projected to create over 55,000 jobs by 2016, representing one in every seven new jobs in the state. Nationally, these jobs are projected to increase by almost 3 million to represent one in every six new jobs by 2018. 

“The findings of this study underscore what we’ve always known to be true – that Nashville’s health care industry is unique to other markets, especially in the creation of jobs, both locally and globally,” said Murat Arik, PhD, associate director of the Business and Economic Research Center (BERC) at the Jennings Jones College of Business at Middle Tennessee State University (MTSU) and lead researcher for the project. 

In addition to analyzing the economic impact of Nashville’s health care industry, the study included a survey of Nashville Health Care Council member CEOs. “Ninety-five percent of Nashville Health Care Council member CEOs indicated that a Nashville headquarters location is important to their company’s positive performance,” said Council President Caroline Young. “Nashville’s long-standing reputation as a health care hub is reinforced by a culture of entrepreneurialism and creativity, key elements for continued growth and innovation in this industry. In our 15th year, the Health Care Council continues work to foster these qualities here.”   

Conducted by BERC at MTSU, the report examined the impact of the health care industry on business revenue, personal income, employment, office space and other factors. This study is a follow up to a report commissioned by the Health Care Council in 2005. 

Key Study Findings of the Nashville Health Care Industry: Economic Impact

  • The Nashville health care industry contributes an overall economic benefit of nearly $30 billion and more than 210,000 jobs to the local economy annually. 
  • Globally, 56 health care companies headquartered in Nashville generate more than $62 billion in revenue and nearly 400,000 jobs.
  • More than 250 health care companies have operations in Nashville and work on multi-state, national or international basis, with more than 300 professional service firms (e.g., accounting, architecture, banking, legal) providing expertise in the health care industry, according to Nashville Health Care Council data.
  • Seventeen publicly-traded companies are located in Nashville with combined employment of more than 145,000 and revenue of nearly $26 billion globally.
  • The health care industry is Nashville’s largest and fastest growing employer, directly employing 110,000.
  • One in eight Nashville workers is employed by a health care provider.
  • The Nashville health care industry generated $13 billion in personal income for the local economy in 2008.
  • The average annual wage of the Nashville health care industry is $53,000, significantly higher than the average Nashville wage of $39,000.
  • In 2008, total estimated taxes paid by the Nashville health care industry in Tennessee were $1.2 billion, which represents nearly 20 percent of all taxes collected in Nashville and 7 percent of all taxes collected in Tennessee in 2008.

Nashville Health Care Council Members

  • Council members directly employ nearly 70,000 people in Nashville and 375,000 globally.
  • Council member companies pay an average annual wage of approximately $70,000, almost double the average Nashville annual wage of $39,000.
  • A survey of Council member CEOs shows great confidence in the Nashville market; 95 percent indicated that a Nashville headquarters location is important to their company’s positive performance. 
  • Approximately half of Council member CEOs believe that health information technology is the most promising sector to enter today.

About the Study:The study examined core clinical providers, which include ambulatory services, hospitals, and nursing and residential care facilities operating locally; and the greater health care industry that encompasses these clinical providers and other related health care companies such as health care services management, managed care, life sciences and professional services firms that operate on a local, national or international basis. The study also surveyed and profiled approximately 150 member companies of the Nashville Health Care Council and used the most current and comprehensive industry data available to analyze member business operations and CEO confidence. This most recent analysis is a follow up to a study commissioned from MTSU by the Nashville Health Care Council in 2005. View the current and previous studies at

About the Nashville Health Care Council:The Nashville Health Care Council, founded in 1995 as an initiative of the Nashville Area Chamber of Commerce, is an association of health care industry leaders working together to further establish  Nashville’s position as the nation’s health care industry capital. For more information on the Council, please visit 

About the MTSU Business and Economic Research Center (BERC):The MTSU BERC supports the public service activities of the Jennings A. Jones College of Business.  The organization engages in a variety of educational and research activities aiding businesses, government, civic organizations and other interested individuals to help them understand the economic and business climate of Tennessee. For more information, please visit 

 * Only companies with more than $500,000 in revenue and at least 100 employees are included in this analysis.   

Nashville Health Care Council | 211 Commerce Street, Suite 100 | Nashville, TN 37201
phone  615.743.3140 | fax  615.743.3149 |

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Small But Mighty: Rural Hospitals Cope With Many Challenges – July 28, 2009

By Barbara Kram, Editor
This report originally appeared in the July 2009 issue of DOTmed Business News

As politicians in Washington duke it out over health care, rural and community hospitals are certain to be a focus. The mission of primary care, the need for chronic disease management and caring for the uninsured are priorities for small hospitals and for national health policy. Whatever form reform takes, the nation’s rural hospitals are likely to benefit, or at least not be overlooked (Policy Update: Government Agencies Showing New Focus on Rural Health).

This sector is no stranger to bureaucracy. No matter what regulations Uncle Sam throws at them, small and rural hospitals, particularly the nation’s designated Critical Access Hospitals (CAHs) are experts at meeting regulatory requirements. Unlike large hospitals that are paid according to diagnoses, CAHs are reimbursed more fully, providing a cushion in hard times that helps to serve a disadvantaged patient base.

“The PPS or prospective payment hospitals are paid on a DRG or diagnosis related group. CAHs are paid on a cost basis,” said Lora Key, CEO of Sabetha Community Hospital, a CAH in Kansas. “Through the year, Medicare will set an interim rate for us. Depending on our patient loads, they may be underpaying us or overpaying us. That Medicare cost report is like a tax return at the end of the year – either we owe them or they owe us.”

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ARx Spells the Difference in Hospitals Staying Afloat – April 28, 2009

DotMed.Com News

By Rabia Paracha, DotMed.Com Project Manager

(For full story, go to:

Business, administrative, and office functions of a hospital are almost as important as the clinical functions to the quality of care provided. In fact, these office functions can spell the difference in staying afloat. The most successful provider organizations recognize the need for a business partner who can generate all the revenue to which the organization is entitled.

ARx, LLC, a Tennessee-based company has provided business office operations and revenue cycle services to hospitals of all sizes since 1997. ARx clients include some of the largest health care organizations in the country as well as small and rural independent hospitals, including an increasing number of Critical Access Hospitals.

Many companies offer claims management, billing and collections, but ARx is unique in its expertise in hospital administration. The company was founded by administrators from major hospital chains.

“We’re not a collections agency or a company that buys back debt from hospitals. There are a lot of players like that,” said J. Merle Glasgow, Vice President of Sales and Marketing. “As business office specialists, we are a value-added extension of the hospital’s back office operations.”

With over 115 years of combined health care industry experience, the ARx executive and operations management team takes a hands-on approach to complement their clients’ existing business office infrastructure to improve results, reduce accounts receivable (A/R) days, increase cash collections and enhance overall financial performance.

“With everything changing and evolving, especially government payors such as Medicare and Medicaid, it is key to stay on top of current regulations,” Glasgow said. “You might be leaving money on the table when it comes to reimbursements if you’re not up to speed on the current rules and guidelines.” He noted that hospitals are faced with particular stresses now as Medicare is using third parties to audit and recoup past claims paid. Hospitals that aren’t billing correctly leave themselves open to these recoveries, along with violations and penalties if CMS finds it has overpaid.

Another core competency of ARx lies in their database compatibility. “We are not a technology company trying to get into the service space. We don’t sell technology so our core focus is service within the hospital business office,” Glasgow said. “We have integrated with all the major IT systems out there and patient accounting systems. We are very flexible when it comes to being able to receive data feeds from our clients’ end regardless of the format, take that data, manipulate it for maximum efficiency within our environment, and securely provide timely updates back to their systems.”

A Prime Example of Their Work
In 2006, a not-for-profit, integrated health care system in the eastern United States purchased a 60-bed Community Hospital from another large hospital system. At the time of acquisition, the hospital was operating without a business office and the health care system and the acquiring company realized an interim business office solution was needed in order to successfully integrate the Community Hospital into the company’s central business office.

ARx was referred to the acquiring company as an experienced resource to handle the full business office requirements of the Community Hospital until the system conversion was complete. ARx aided integrating the Community Hospital into the existing company by acting as a hands-on seamless extension of their current infrastructure within a span of two years. With the help of ARx, the Community Hospital successfully submitted bills within 5 days of the conversion, reduced A/R of $22 million by more than 96 percent with the remaining 4 percent in patient payment arrangements, and resolved all outstanding credit balances.

ARx picks up the claims and billing process after the patient visit and coding is done. Relationships with hospital clients range from a full business office outsourcing agreement to a partial engagement. For instance some institutions still prefer to do the initial billing.

“The hospital staff may get the bill out and do the initial followup and then turn it over to a third party like ARx after 20-30 days to work out the remaining issues,” Glasgow said. “We prefer to do the billing so we can speed up the receivables process. But some hospitals like to hold on to that particular aspect of their operation and bring us in afterward.”

He noted that generally hospitals focus on the front end — patient intake — and let ARx take care of the back end.’s Barbara Kram contributed to this report.

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Case Study – Full Business Office Outsourcing Services


The ARx client featured in this case study is a not-for-profit, integrated healthcare system in the eastern United States that serves more than 3.5 million people in 34 counties spanning three states. The system has over 26 facilities that include large acute care hospitals, small rural hospitals and a number of outpatient centers and specialty clinics.


In 2006 the healthcare system purchased a 60-bed Community Hospital from another large hospital system. At the time of acquisition, the hospital was operating without a business office due to the previous owner’s “shared services” strategy which included a centralized business office environment. Since the acquiring hospital system utilized a similar approach, the eventual plan was to roll the Community Hospital’s A/R into the new company’s central business office. It would not be possible for the transition to immediately occur however, as the hospital needed to be converted to the new company’s operating environment. In the meantime, hospital revenue was expected to continue under the older A/R system until March of 2007. In addition, issues such as Provider number-related delays with governmental payers were starting to become a concern. As a result, the acquiring hospital system realized that an interim business office solution was needed.


Due to the selling hospital system’s positive experiences with ARx during previous ownership transition events, and throughout the extended roll out and migration period of their internal shared services strategy (which created internal demand for interim business office solutions), ARx was referred to the acquiring company as an experienced resource to handle the full business office requirements of the Community Hospital until the system conversion was complete.

ARx Full Business Office Services included:

  • Set up and maintained master files
  • Worked all Business Office unbilled alerts and coordinated Medical Records and Admitting alerts
  • Provided billing service for all new and re-billed claims
  • Provided all insurance collection services
  • Set up lockbox for payment processing
  • Provided all cash posting and G/L balancing
  • Performed credit balance reviews and processed insurance/ patient credit balance requests
  • Worked managed care denials and discrepancies
  • Logged and tracked all Medicare Bad Debt
  • Submitted quarterly Medicare Credit Balance Reporting
  • Worked and maintained all correspondence
  • Worked all self pay accounts (Letters and phone calls)
  • Submitted self pay accounts to primary agency after early out cycle was completed
  • Provided monthly A/R reports and ad hoc report requests
  • Held weekly conference calls throughout project

Outcomes included:

  • Bills were submitted within 5 days of the conversion
  • Achieved high resolution percentages of outstanding gross A/R monthly
  • Reduced A/R of $22 million by more than 96% (remaining 4% is patient payment arrangements)
  • Resolved all outstanding credit balances


The healthcare system successfully completed the Community Hospital’s system conversion in the Spring of 2008 and is now utilizing ARx’s Data Warehousing services on an ongoing basis.

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