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Explore our Integrated Revenue Cycle Approach
Scheduling sets the tone of the patient experience and the revenue cycle. Is your organization collecting the critical data necessary to prevent denials and other downstream issues? Is your call center performing at best practice levels in order to prevent revenue leakage?
Pre Registration & Insurance Verification
Nationally, more than 55% of initial claim denials are attributed to errors in insurance and demographic information. RCS will evaluate your current processes and existing technology, and make practical recommendations to accelerate cash and reduce associated AR and bad debt, while significantly reducing expenses in claims processing and re-work.
Is your organization collecting at least 30% of patient payments at the point of service? Whether you’re collecting a little or a lot, RCS will develop a comprehensive plan to exceed your point-ofservice collection goals.
Are you leaving money on the table? When was your last Charge Description Master (CDM) review? Is your organization’s CDM and charge process accurate and complete? Do your patient care departments complete charge reconciliations daily? RCS offers full-scale CDM reviews and departmental education to substantially increase revenue
Clinical Documentation Integrity
Clinical Documentation Integrity (CDI) can drive the facility’s case mix index, as well as risk adjustment factor. RCS has worked with facilities to proactively address CMI shortfalls through education of physicians and CDI staff.
Clinical denials can be detrimental to the revenue cycle. RCS has extensive experience summarizing payer contracts for facilities and assisting hospitals in improving patient outcomes.
Health Information Management
The Discharged Not Final Coded (DNFC) amount is a key performance indicator (KPI) for the Health Information Management department. Is your DNFC amount increasing while your Case Mix Index (CMI) is decreasing? Let RCS assist you in reducing this level to best practice.
Are you meeting your Discharged Not Final Billed (DNFB) metric on a regular basis? Are you monitoring adequately this KPI to identify issues quickly? RCS has experience in assisting clients in reducing significantly their DNFB.
One method of improving cash flow is to reduce the organization’s net AR days. What is your follow-up process? What is your trend for net AR days? RCS will evaluate your billing processes and identify opportunities to positively impact your net AR days.
Applying payments to outstanding accounts in a timely manner helps an organization’s financial health. How quickly are you posting cash? RCS will assist with assessing your current processes and identify opportunities to meet best practice in cash application.
RCS saves our clients money by optimizing existing technologies, without adding excessive and unnecessary bolt-on systems.
People Processes & Technology Working as one
“Cash was backed-up due to coding; charges were lower than contracted payer rate schedules. RCS started with strategic pricing assessment and in a short period of time, this analysis helped increase monthly cash collections, days of revenue in A/R decreased, and upfront collections doubled.”
Robert Frank, CFO, Weirton Medical Center, Weirton, West Virginia
“Over my 34 years as a healthcare executive, I have used a number of consultants for a variety of operational improvements. I can attest that RCS has been the best by a far margin! RCS has delivered results through experienced executives, detailed and thorough reports and attainable action plans.”
Richard Allen, CEO, Warren General Hospital, Warren, Pennsylvania
“During their comprehensive look at our revenue cycle–from A to Z–RCS looked at all of our technology solutions. We weren’t maximizing the effectiveness of these; most were between 50% and 70% utilized. This was a big benefit of the engagement.”
Tom Albanesi, CFO, Excela Health, Greensburg, Pennsylvania