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REVENUE CYCLE & DATA ANALYTICS CONSULTING

Hospital Lab Outreach, Clinical Labs, Molecular Diagnostics Labs,
Pathology Groups, Physician Practices, and Radiology Services

  • Identify revenue cycle deficiencies
  • Expected reimbursements
  • Payer perfomance
  • Workflow efficiencies
  • Set up revenue cycle analytics
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 Revenue Cycle Management Consulting 

Revenue Cycle Management Consulting

Background

Extensive experience in leading, building, training, and facilitating revenue cycle operations addressing hospital lab outreach, commercial labs, molecular diagnostics, pathology, physician specialties, and radiology services. For work history, visit About Us.

Client Engagements

Observe current workflow, interpret data, identify root cause issues that impact trends. Develop recommendations for process improvement and implement new processes improvements in collaboration with stakeholders to improve and measure results/outcomes.

Consulting Services at a Glance

  • Provide leadership and direction to maximize revenue and ensure compliance adherence.
  • Actively coach, counsel, and develop others to achieve operational objectives.

  • Analyze revenue cycle processes with focus on improving receivables and reducing bad debt expense. This includes developing, revising, and enforcing policies, goals, and best practices to effectively manage client receivables.
  • Trend and analyze key revenue cycle metrics to effectively monitor and improve revenue cycle performance.

  • Review, establish, and monitor revenue cycle performance measures (KPI’s).
  • Examine the patient collection process including account balance accuracy, timely billing, and follow-up.
  • Examine the credit balance resolution process check for compliant and timely workflow for both payor and patient balances.
  • Examine the process of financial forecasts and month-end financial key performance reporting.
  • Considerable knowledge and experience supporting and developing reporting and analytics for research, process improvement and correcting negative trending.
  • Data Analytics Reporting
  • Track Billing Edits, Errors & Rejections
  • Lag Time reporting averages
  • CPCA Reporting Monitors
  • Identify where your business volume is coming from

  • Project management oversite: scope of responsibility, impact analysis, outcome modeling, communication to key stake holders.
  • Implement and oversee new and existing regulatory requirements to reduce billing errors and maximize reimbursement.
  • Develop and maintain process improvement in the revenue cycle.
  • Identify outstanding items and convert into a project with expectations, deliverables, and regular project updates.
  • Identify and develop objectives, policies and procedures affecting billing, collections and cash posting.
  • Setup of the overall revenue cycle goals for the organization, setting process and outcome metric goals and monitoring progress toward achieving them.
  • Always ready to collaboratively work with information technology team to resolve any system challenges or issues impacting revenue cycle functions or implementation of IT initiatives.
  • Work with client to lead measurable and sustainable improvements for example: charge generation, coding, billing/follow-up, denials, cash collections, patient pay, and bad debt reduction.

Leverage our expertise and let us find the right solutions for your business! We have the know-how & tech solutions for every challenge.

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 Data Analytics Consulting 

Data Analytics Consulting

Background

Technical background in building reports (revenue cycle) using data mining tools linking one or multiple databases to address the reporting needs specific to: hospital lab outreach, commercial labs, molecular diagnostics, pathology, physician specialties, and radiology services. For work history, visit About Us.

Data is a powerful agent for change and because of this, it is important to know how the data is gathered, cleaned, and presented to tell a story. Analytics combined with operational knowledge can turn you into a “data detective”. The key to being an exceptional “data detective” is to have the tools of the trade, in this case, a set of dashboards with defined acceptable ranges where you want your revenue cycle to be. Think of a traffic light that has three stages of warning: green, yellow, and red.

This monitoring approach drives accountability, creating opportunities to be proactive instead of reactive. To capitalize on your analytical toolset, you need to group reports into categories. For example: auditing, laboratory statistics, financial statistics, and Rev cycle operations. From this point, you would develop the process to define set up, implement, and maintain these reports.

Custom Reports Created at a Glance

Analytics reporting is crucial in today’s fast-moving environment. You can use it as a fire fighting tool to define the casualties in lost revenue or as a monitoring tool in revenue loss prevention. How it is deployed and maintained requires deep analytics skill set, this is where I can assist your organization.

  • A majority of payers enforce aggressive timely filling limits (60, 90, 120 days). Tracking insurance claims successfully before the timeline expires is critical to prevent denials that result in write off’s.
  • Tracking billing edits, errors, rejections, and denials provide a sense of how clean your registration process is and how efficient you billing workflow is compared to industry best practice benchmarks.
  • Ordering locations sorted high to low identifies where your business volume is coming from (ordered tests) and how much effort (edit/error processing) is required to maintain a particular client’s business.
  • Reimbursement tracking sorted by test, payer, gross charges, expected reimbursement and actual reimbursement give you the ability to monitor the expected vs. actual payment amount.
  • Daily CPCA reporting monitors, charges, payments, contractuals, and adjustments. You will be able to react to drops in payments and trend months out for pattern tracking.
  • Lag time reporting averages the time needed to generate charges, bill the claim, post the payment using the data of service as a starting point and the final posted payment as an ending point.
  • Tracking the number of times an insurance claim is worked/touched by different users.
  • End of month financial indicators track multiple areas providing a snapshot of critical financial targets on a month-to-month performance.
  • Exception based tracking filters and reports only what you want to monitor and measure.
  • Grouping your ordering physicians by medical specialty allows you to track what tests they are ordering based on their specialty.

We turn your data into actionable insights. Schedule your free data visualization consultation today!

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