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Revenue Cycle Review

Maintaining the status quo can be costly. As health care operating margins shrink, you need to find efficient and innovative ways to capture and collect revenues. If your revenue cycle has not undergone a comprehensive assessment within the last two years, you’re probably leaving money on the table.

Challenge | Services | Approach | Benefits

Challenge

Revenue problems rarely stem from a single source; they are most often the result of deficiencies in education, training, staffing, workflow, and computer software. Each deficiency must be addressed as part of a coordinated solution to obtain real improvement, without disrupting your operations or alienating your staff.

Our Services

Revenue Cycle Solutions will work with you to analyze your current revenue cycle operations and focus on innovative, cost-effective ways to improve revenue capture and collection. Our experienced consultants will gather the information necessary to provide you with detailed recommendations in the following areas:

  • Scheduling / Pre-registration
  • Admissions / Registration
  • Insurance Verification
  • Charge Processing
  • Charge Description Master (CDM)
  • Case Management
  • Health Information Management (HIM)
  • Billing
  • Follow up / Collections
  • Payment Posting
  • Bad Debt / Agency Management
  • Vendor Management
  • Managed Care Contracting

Our Approach

Revenue Cycle Solutions’ consultants will work with your senior management team to understand its concerns, review operations, and establish objectives. From there, Revenue Cycle Solutions will:

  • Create applicable indices and benchmarks (KPI scorecard) for all phases of the revenue cycle
  • Prepare a detailed analysis of all significant revenue cycle processes, including issues relating to compliance with HIPAA privacy regulations
  • Provide a detailed management assessment report containing recommendations for improvement
  • Compile a comprehensive work plan to ensure accountability in the timely implementation of all recommendations
  • Complete work in a timely manner, typically four–six weeks after obtaining all pertinent information to complete our analysis
  • Actively participate and lead work plan implementation efforts

Benefits

Following a comprehensive and customized revenue cycle review, hospitals and healthcare systems typically experience total operating margin improvement, cash acceleration, and expense reduction. These quantifiable results also lead to overall process improvements in a variety of areas, including:

  • Increased accuracy of account information
  • Timely verification and processing of pertinent account information
  • Improved timeliness and accuracy of charge postings
  • Shortened time frame from discharge to final bill
  • Reduced volume of claim denials
  • Reduced Accounts Receivable days outstanding
  • Lower bad debt and charity write-offs
  • Increased cash flow
  • Mentoring and training of applicable staff leading to self-reliance