Revenue Cycle

All too often the revenue cycle is perceived as simply the billing and collections function of a single department, with maybe a remembrance of the importance of admitting and registration. In truth, it is far more complex and includes a multitude of components that are all subject to ever-changing requirements.
The importance of keeping your Revenue Cycle performance at peak levels is seen in industry experience and research. Studies show that most organizations can achieve an improvement of up to 4% in their Net Revenues by maximizing their Revenue Cycle operations. Successfully capturing Revenue Cycle improvement opportunities will achieve cost control and bottom line improvements, a necessity in the increasing environment of decreasing reimbursement.
Health Care Program Advisors is one of the few firms on a national level that can fully address the complete Revenue Cycle. Our extensive knowledge and expertise drives value by helping your organization design and implement a comprehensive improvement agenda that maximizes the strengths of all who can and should be involved, including your staff.
Our services around Revenue Cycle focus in three primary areas:
  • Assessment
  • Implementation
  • Contract Advice/Management

  • Assessment
    Our first efforts are to understand your current environment and operations to determine the specific areas and extent of improvement potential.
    • If a general validation of a specific component of improvement is desired, the Assessment is typically completed in a matter of two weeks.
    • If there is need for more comprehensive or detailed understanding of the opportunity, including definition of the corresponding implementation requirements and Return on Investment (ROI), then the Assessment will extend to six or eight weeks.
    • At the completion of the Assessment, we will work with you to develop the Program Agenda for pursuing the appropriate mix of implementation and contracting for your organization.
  • Implementation
    For organizations that have sufficient numbers and capabilities of resources, the implementation efforts might be a matter of helping to manage the improvement program. This includes:
    • Monitoring the implementation plans;
    • Participating in status updates;
    • Measuring the benefit achievement and providing experience and leading practice knowledge to your internal team.
    For organizations that lack the numbers and depth of resources, the implementation processes are more involved and require additional professional support. This includes:
    • The use of regional or national firms that bring specific expertise and/or resources to facilitate the rapid realization of improvements.
    • Our advisors bring the knowledge and expertise on how to select, contract and manage outside resources. We have the knowledge to create a matrix for success, as well as the specifics on how to measure success. We advise on how fees should be negotiated, monitored and paid.
    Depending on the specific areas of opportunity defined in the Assessment report, Implementation ranges from six to nine months. More focused components of implementation (e.g., establishing a time of service collection practice) can be accomplished in shorter time frames.

     

  • Contracting Advice/Management
    The definition, selection and management of appropriate business partners (e.g., bad collection, Medicaid eligibility processing) is one of the keys to success within any Revenue Cycle operation. In addition, few organizations can or should perform all of the Revenue Cycle functions internally.
    Health Care Program Advisors uses extensive expertise and experience to advise on:
    • Structuring business relationships.
    • Selecting Revenue Cycle outsourcing services, including how to:
      • Fully consider all options
      • Select the best vendor
      • Structure the management processes for outsourced (either partially or fully) operations