The revenue cycle is how your practice converts the services you perform and/or products you sell, into revenue. While this function used to be considered just “billing and coding”, it’s now recognized that the key to revenue is so much more complex than that and the concept of revenue cycle management formed.
We know the revenue cycle in and out, from the day-to-day functions of all people involved to the high-level strategic management, and everywhere in between. This enables us to identify breaks in even the most complex processes and to identify areas with opportunities for improvement.
For our Comprehensive Revenue Cycle Review, we evaluate your entire revenue cycle. Some of the things we look at (based on your practice) may be:
- Workflows & Processes
- AR followup (including no-response)
- Charge Capture (office and facility)
- Claim submission methods and frequency
- Data entry and quality assurance
- Denial and rejection correction
- Denial appeals
- Eligibility & benefits verification
- Financial counseling & patient assistance
- Knowledge and training level of staff
- Monthly and yearly financial closing processes
- Patient statements and collections
- Pre-bill claim edit (i.e. front end edits) adequacy and appropriateness
- Relevant policies & procedures
- Relevant job descriptions
- Task assignments
- Report Analysis
- Case cost analysis (if applicable)
- Contractual payment variances (ex. underpayments)
- Denial and rejection root cause
- Employee performance
- Fee schedule / chargemaster
- Key Performance Indicator (KPI) Analysis vs industry and specialty benchmarks (ex. charge lag, days in AR/DSO, denial rate, etc.)
- Payer performance metrics
- Vendor (ex. outsourced billing) performance (if applicable)
- Technology Utilization
- Automation of routine tasks
- Denials and rejections analysis
- Electronic Funds Transfer (EFT) / Electronic Remittance Advice (ERA) utilization
- Eligibility and benefits verification
- Outsourcing (where appropriate)
- Patient portal
- Payment capture
- Documentation / Charge Capture Analysis
- Accuracy and appropriateness
- Ancillary service capture
- E&M utilization
- Integrity (completeness)
From observing and evaluating the actual day-to-day operational functions to comprehensive evaluation of reports, we will help to identify areas of opportunity.
We don’t just tell you how to improve, but we will teach you how. We also will teach you how to identify and resolve issues proactively, so that you truly maximize your revenue. We will work directly with you and your team to achieve success!
Do you know how your practice performs as compared to industry benchmarks for your specialty(ies)? Do you know what your key performance indicators (KPI) are (such as your denial rate, Days in AR (DSO), and first pass payment rate)? Do you know how each of your employees is performing? Do you know why? Do you know how to improve these efficiently? If you answered no to any of these, we can help!
Ready to find out how a Comprehensive Revenue Cycle Review can help your practice?
We understand that relationships are about people, not web pages. That's why we offer no-risk no-obligation consultations.
