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Revenue Cycle

Improvement and change can be difficult to incorporate into the daily operations of hospitals and physician practices. Factors such as decreases in reimbursement (due to Medicare and Medicaid funding cuts), increases in the uninsured population, declines in margins, and pressures from managed care organizations demand process improvements in the revenue cycle.

We can help achieve improved operational results by maximizing revenue and improving cash flow for your organization.

Services Overview

  • Accounts receivable assessment and action plan
  • Behavioral health coding and billing consulting
  • Case mix analysis
  • Coding reviews: MS-DRG, hospital outpatient, and
    physician
  • Chargemaster reviews with education and training
  • Chargemaster re-modeling and pricing
  • Charge capture/clinical documentation
    improvement reviews
  • HIM staffing and interim coding assistance
  • Home health and hospice coding and billing consulting
  • Implementation assistance
  • Operational practice assessments
  • Patient access optimization, centralized scheduling
    and pre-registration
  • Practice management services
  • Provider enrollment and credentialing
  • Provider-based consulting
  • Rural health clinic/FQHC consulting
  • Specialty coding and billing education: cath lab, IR,
    radiation therapy, etc.
  • Supply/pharmacy revenue cycle management
  • Telehealth consulting services
  • Therapy operations and referral development
  • 501(R) compliance

IRS 501(r) Compliance: Financial Assistance Policy and Amounts Generally Billed Calculation

Non-profit hospital organizations as defined by Section 501(c)(3) must meet requirements imposed by Section 501(r) on a facility-by-facility basis to be treated as a tax-exempt organization. According to the Internal Revenue […]

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Hospital Price Transparency: What’s New in 2024 and Beyond

The Centers for Medicare & Medicaid Services (CMS) has introduced significant changes to the requirements for hospital price transparency. The aim is to enhance pricing transparency and ensure compliance with […]

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How to Manage Clinical Validation Denials

In the past several years, hospitals have continued to feel the impact on revenue from Clinical Validation Denials (CVD). The need for a robust CDI team to capture support for […]

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Connect with our team.

To learn more about our services and areas of expertise, send us a message.