Revenue Cycle Optimization
Navigating Financial Health: Unlocking Potential with Strategic Healthcare Revenue Cycle Management
Revenue is vital for the survival of any business, including healthcare entities such as hospitals, health systems, and physician groups. The healthcare sector faces unique challenges with tight profit margins and strict regulations. Unfortunately, many institutions neglect or underinvest in effective revenue cycle management, treating it as a secondary aspect of their operations.
Our team specializes in comprehensive revenue cycle assessments for healthcare organizations. We focus on turning financial deficits into surpluses through a meticulous approach:
- We conduct thorough examinations of the revenue cycle, analyzing both the central business office (CBO) and front-end processes at the ambulatory practice level.
Benchmarking and Analysis:
- Our experts review data to benchmark against industry best practices, ensuring accurate assessment and identification of areas for improvement.
- We pinpoint opportunities for revenue enhancement related to lag days, charge capture, coding, write-offs, and accelerated accounts receivable capture.
- We scrutinize processes, policies, and procedures to identify any inefficiencies or bottlenecks affecting the revenue cycle.
Interworking and Communication:
- We assess the interworking between practices and CBO models to ensure seamless continuity, communication, and feedback.
Staffing and Management:
- Our evaluation includes a review of staffing, staff fit, and management span of control to optimize resource allocation.
- We assist clients in implementing necessary changes through action plans and prioritize critical tasks for a smooth transition.
- We help establish key performance metrics (KPIs) and, if requested, provide ongoing support in managing the process.
A standard revenue cycle assessment covers key areas, including:
- Revenue cycle management overview
- Clinic management structure
- RCM operational assessment
- Pre-visit, visit/encounter, and post-service functions
- Remittance processing, rejections/denial management
- Practice technology, fee schedule, and payer matrix
Our experienced advisors identify weaknesses in the revenue cycle, quantify financial losses, and propose best-in-class solutions to enhance efficiency and increase revenue.