Revenue Cycle Management systems help strengthen revenue by minimizing claim denials, reducing days in accounts receivable, and increasing collections. As a result, healthcare providers receive correct and timely payments and optimize financial performance. Effective RCM also can help healthcare organizations comply with regulatory requirements and improve patient satisfaction. Analyzing the current Revenue Cycle Management process is key to identifying steps to improvement and growth.
Comprehensive analysis to identify efficiency recommendations & establishment of benchmarks
- Billing Operations
- Timeline Analysis:
- Service Delivery
- Claim Approval
- Payer Submission
- Rejection & Denial Management
- Payment Application
- Historic Claim Volume & Coding
- Timeline Analysis:
- Clinical Operations
- Services Provided & Opportunities for Growth
- Staff Polices & Procedures vs Actuals
- Authorization Tracking
- Clinical Workflows
- Gaps Between Service Delivery vs Billing
- Accounts Receivable
- AR Aging (30,60,90 & 120+)
Contracting & Credentialing Review
- Review of all existing MCO contracts
Outstanding Claims Review
- Review all existing outstanding claims
- Identify source & solution
Clinical Documentation Review
- Review and analysis of clinical records