Revenue cycle operations are some of the most complex functional areas in health care organizations and serious consequences can unfold when not properly managed.

Risks can include payment delays, permanent cash and revenue loss, wasted time and resources, and in some cases, government sanctions from failing to comply with federal regulations. Managing this complex function in the highly regulated health care industry is a challenge for all service providers due to complex contracts, payor rules and technology, staff turnover, and other factors.

Learn to improve cash flow, streamline operations, reduce variation, and effectively turnaround operations for your organization with comprehensive revenue cycle solutions from our professionals.

Implementing operational improvements to your revenue cycle could save your organization hundreds of thousands to millions of dollars, and potentially result in 12 times return on investment.

How the Process Works

Across the continuum of patient scheduling and registration, health information management, patient and general ledger accounting, IT and contracting, we collaborate with your teams and leverage our cross-functional expertise to develop a deep understanding of each aspect of your revenue cycle.

We identify risks and performance gaps that inform development of implementation plans to provide actionable information to improve operations. We benchmark your performance against best-in-class key performance indicators (KPIs) and analyze your operations based on our decades of hands-on experience.

Once we help identify opportunities, we plan, develop, and implement corrective measures that meet your objectives.

Operational Revenue Cycle Assessments and Improvement Implementation

Accelerate cash flow, decrease aged receivable (AR) days and AR through a range of services—from customized initial assessments to consistent cash acceleration and operational improvement projects—until you achieve your financial goals. 

Projects can include the following.

Operational Performance Measures

• Benchmarking evaluations of KPIs based upon industry best practices
• Implementation of ongoing performance measurement tools
• Analysis of bill edits and clean claims processing improvement
• Drafting or revising policies and procedures
• Cash acceleration strategy and implementation
• Staff assessments, including creating a measurement and reporting tool for employee performance

Business Process Improvement

• Assistance creating denial management practices
• Root-cause analysis and real-time improvement where appropriate
• Redesign of workflow
• Review of Charge Description Master (CDM), documentation, coding, and billing processes
• Analysis of outsourced billing agencies and revenue cycle vendors
• Outsourcing or insourcing business office functions

Technology Systems Operational Support

• Revenue cycle system use and design reviews and operational improvements
• Pre-system conversion analysis and preparation
• System conversion support and assistance
• Post-system conversion recovery to best practice benchmarks
• Billing system and edits implementation
• Contract management system builds and implementation

Additionally, we provide support in other related areas such as vendor management, operational improvement, sophisticated analytics, strategy, or government compliance services.

Support at Every Cycle Stage

Our professionals provide planning and operational expertise at every step of the revenue cycle. We can help you comprehensively or with selected areas to address specific challenges. Ongoing performance measurement and periodic check-ups in each area can help support a healthy revenue cycle.

We help our clients create sustainable change by delivering results that help improve cash flow and reduce waste.

Organizations that often benefit from revenue cycle solutions include:

• Multihospital systems
• Freestanding hospitals and clinics
• Large multispecialty physician groups
• Long-term care facilities such as skilled nursing or long-term acute care facilities
• Federally Qualified Health Centers (FQHCs)
• Behavioral health providers
• Home health and hospice agencies

With decades-long industry experience directing operational and revenue cycle departments in hospitals, FQHCs, multifacility settings, central billing offices (CBOs), clinics, and physician practices, our professionals have first-hand knowledge and understanding of the challenges health care organizations face and how the revenue cycle should function. 

In addition to providing high-level operational analysis, our experience with a multitude of revenue cycle systems informs our solutions based on tangible experience. This real-world perspective uniquely prepares us to gain a first-hand understanding of your revenue cycle to assist your team in implementing improvements, enhancing workflows, and driving operational efficiency.

Versed in numerous electronic medical records, patient accounting, and practice management and billing systems—including EPIC, Cerner, NextGen, Centricity, Paragon, eClinical Works, Trizetto, and Change Healthcare, our professionals understand the tools and processes that can influence and impact your operations.

We craft solutions best suited for your organization. Rather than focusing on short-term fixes, our approach focuses on making your operations work for your organization. We provide customized solutions that empower your teams to enhance your revenue cycle.