How Texas Institute for Surgery Increased Cash Flow and Decreased AR Days

Jun 28, 2024
Article Background

Texas Institute for Surgery is a state-of-the-art surgical facility dedicated to providing high-quality care to patients in North Dallas. It offers a wide range of surgical specialties, attracting a diverse patient population. Despite its commitment to patient care, the acute care hospital faced several challenges hindering its financial performance and operational efficiency.

The challenge

The business office staff at Texas Institute for Surgery was not well versed in the intricacies of modern healthcare billing and claims management. High staff turnover further complicated matters, as new employees required extensive training to manage the daily influx of claims.

What started off as a partnership for medical coding services in 2013 turned into much more. Texas Institute knew they needed help after the hospital’s affiliation with an umbrella company decided to limit its control over purchasing decisions and restrict its independence as a healthcare provider. They knew they could depend on TruBridge.

The solution

Texas Institute for Surgery partnered with TruBridge to implement the nTrust program, a comprehensive solution designed to address their key concerns as a business office while supplying the EHR applications they needed at no additional cost. This package encompassed multiple tools and services:

Complete Business Office (CBO): TruBridge’s expertise equipped the hospital’s staff with the knowledge and tools to optimize billing and claims management, fast
Data integration: Seamless data integration facilitated by TruBridge’s solutions allowed Texas Institute for Surgery to leverage its patient data for population health initiatives, illuminating valuable insights to enhance patient care strategies.
Financial technology: nTrust streamlined the claims submission process, leading to faster reimbursements and improved cash flow.
Electronic health record (EHR) all-access: With all-access to TruBridge EHR and an annual optimization, Texas Institute could perform and use the system and its tools to the fullest potential.
nTrust proved to be the perfect solution for Texas Institute for Surgery. They didn’t have to pay out of pocket for the different RCM and outsourcing solutions they benefited from that they otherwise would have had to pay for if they purchased all of those things without nTrust.
Chris Fowler bio photo

Chris Fowler



The nTrust program with TruBridge yielded significant results for Texas Institute for Surgery. The hospital experienced a 15% increase in average monthly cash collections, a direct result of TruBridge’s RCM expertise. A 23% decrease in accounts receivable (AR) days further improved cash flow. The claim-to-collect rate soon averaged just 13.7 days across all payers.

TruBridge’s comprehensive review also resulted in nearly $170,000 of savings in EHR licensing fees. nTrust eliminated the need for subscriptions, resulting in cost savings of approximately $25,000.

Finally, by partnering with TruBridge, Texas Institute for Surgery retained control over purchasing decisions, ensuring its autonomy as a healthcare provider.


Texas Institute for Surgery’s success story exemplifies the transformative power of TruBridge’s nTrust Bundle.

I generally don’t refer to vendors as my partners. However, I do refer to TruBridge as a partner because they share my profits based on the nTrust arrangement that we have with our collections. We share the risk in rural responsibilities and the rewards proportionately.

John Croley

CEO at Texas Institute for Surgery

Through a combination of RCM expertise, data integration tools, and financial technology solutions, TruBridge empowered Texas Institute for Surgery to achieve financial gains, streamline operations, and maintain its independence. The hospital is now positioned to focus on its core mission of delivering exceptional care to patients.