Consulting ServicesOur partnerships and collaborations with healthcare organizations provide practical, tactical and strategic revenue cycle solutions. Our commitment to apply experience from various health systems provides us with the means to achieve our client’s goals. Large and small clients all have a place in our solutions-based consulting practice. Our focus is your focus. Our team’s knowledge pool represents the leading edge of new developments, and we work to leverage that experience into our client’s daily operational landscape. To develop successful solutions we engage everyone along the revenue cycle. Our strength lies in flexibility, reality, and empathy.
Providing a range of revenue cycle solutions for various healthcare provider types, including hospitals, physicians and medical groups, our team seeks to curb the trend of declining payments and increasing denial rates. Our main focus is to increase net revenue by streamlining work and data flow, improving patient throughput, and reducing avoidable write-offs. Data mining is often not enough, but through experience and insight, we optimize the revenue cycle from the EHR to payment posting.
RCM is the bedrock for the evolving patient delivery models of today and the future. What matters is not only the balance of people, places and things, but the management of public opinion. Complex balancing of process and technology will achieve the highest level of revenue realization while managing cost. With so many critical areas of healthcare delivery, RCM leadership must be engaged with HIM, Population Management, Case Management, and Finance departments to ensure all services are appropriately charged, billed, and reimbursed. Public and Community Relations must also be an advisor. With so many department dependencies coupled with complex external healthcare environments, it is easy for even a simple problem to result in revenue loss. Our Consulting team is capable of evaluating data, processes, and technology to develop sustainable solutions.
CM/UM poses significant challenges in managing operational efficiency with increased focus on appropriate patient status and use of resources, while increasing clinical quality. Effective CM combines clinical and financial services, and balances significant coordination and communication between nursing, physicians, and all revenue cycle areas. Our Consulting team reviews the entire spectrum from patient throughput and status, resource management, Recovery Audit Contractor (RAC) programs, denial, and underpayments to ensure proactive operations.
Once thought to be entirely responsible for revenue cycle, PFS has evolved into a communication and information hub. It is the cornerstone for which all services are supported. Even with significant advances in technology supporting PFS functions, the department typically remains heavily dependent on manual processes. Our Consulting team utilizes a variety of analytical tools, reports, and data to identify any opportunities for process improvement. We work collaboratively with our client’s leadership to address distinctive gaps. We are available for short term and long term management oversight assignments during system conversions, management transitions or other strategic initiatives.
Our R.E.A.C.H. Program (Registration, Eligibility, Authorization, Concierge, Hospitality) provides a full suite of patient access resource tools and work flow processes. Proven to reduce errors and denials, increase Point of Service Collections, and ensuring the highest percentage of patients, scheduled and non-scheduled, receive financial clearance discussion (with liability payment and or financial assistance options) prior to service. The R.E.A.C.H. Program also has value-added benefits to healthcare providers, such as proven results of increasing physician and patient satisfaction scores.
While the move from ICD-9 to ICD-10 was a significant event, the daily functions of the Health Information Management (HIM) Department has a financial impact on the revenue cycle. Clinical documentation issues, hybrid documentation, new services, and decentralized data can cause inaccurate coding resulting in denials or reduced payments. Our Consulting team looks at all aspects of HIM, including both internal and external processes and records. We have a variety of HIM resources, including subject matter experts in defensive coding audits along with supportive training tools.