Revenue Cycle
Optimize and collect the revenue you’ve earned, proactively protect yourself from post-payment audits, and maximize your bottom line.
Revenue cycle management (“RCM”) sounds simple enough but ultimately affects nearly all aspects of your organization’s operations, from the requests for an appointment down to the collection of the revenue for services and everything in between. Today, healthcare providers are faced with challenges such as increasing costs, decreasing reimbursement, access to and turnover in talented staffing, suboptimized coding and documentation practices, and overall increasing bad debt write-offs. Without the right advisory team, overcoming these hurdles and creating a well-oiled RCM machine can quickly become a daunting task.
The reality is there is no one-size-fits-all solution to optimizing a revenue cycle. Finding ways to effectively increase profit while providing quality care is rooted in what makes your organization unique.
EisnerAmper’s RCM service line has decades of experience, across modalities, in helping leaders across the healthcare spectrum navigate their unique revenue streams and maximize their bottom lines.
Our Three-Step Revenue Cycle Process
Working through a three-step framework custom built for your health system/provider organization, our team can become fully immersed in your unique processes and revenue streams and leverage tested industry strategies and systems to maximize your income.
1. Identify Opportunities
With a thorough RCM assessment, complete via both a deep-dive process and data performance review, you’ll gain a clear and quantitative understanding of your overall performance segmented by front, middle, backend revenue function performance; provider productivity and coding; and documentation performance.
More importantly, our team will provide you with a clear understanding of your current performance and uncover opportunities unique to your operations. At the end of the engagement, you will understand your current state and subsequent performance, align your vision to key impact areas, identify critical capability gaps for future state, and have a prioritized execution-focused roadmap to achieve both one-time and annual ongoing accounts increases to your financial bottom line—in addition to pinpointing production improvements and cost-reduction areas.
2. Coding and Documentation Sample Review
Through an in-depth audit of sample medical chart reviews, you’ll gain insights into potential over-coding and under-coding issues hindering your revenue stream. Our review includes evaluating your current coding practices to help you establish priorities for documentation improvement, education and training, and identifying and mitigating reimbursement risks. Our goal is to help you improve accuracy and protect earned revenue. Additionally, this step serves as a proactive tool in reducing exposure to post-payment audits by insurance companies.
3. Implementation
As a dedicated healthcare partner, EisnerAmper’s team is here to support your goals over the long run. Upon our findings, we provide a detailed roadmap of changes to obtain the opportunities identified in our assessment. We provide implementation services and, where needed, interim assistance, staff augmentation, and management assistance solutions. In addition, we provide direct to the providers and certified coding staff customized educational services, based upon the actual chart review, to remediate gaps and maximize your revenue.
Our Revenue Cycle Services
Your revenue streams and cycle are unique to your organization. As such, EisnerAmper’s team offers a full suite of services to address the challenges and opportunities you face:
Interim Management and Staff Augmentation:
Provide both long- and short-term outsourced leadership roles from director level, leading RCM and HCIM; to staffing and administration, covering billing, claims, denial management, and payment posting.
Scheduling, Pre-Registration, Insurance Authorization, and Verification Optimization:
Create a more effective revenue forecast by streamlining patient intake, insurance authorization, and payment timelines.
Registration and POS Cash Collections:
Reduce backend staff work and increase cash flow by implementing systems to create efficiencies and ease with accepting and collecting payment.
Medical Records and Coding Review/Education:
Proactively reduce potential coding errors leading to lapses in care, costly penalties, and dissatisfied patients.
CDMP Medical Documentation Management:
Implement fast and accurate documentation strategies so your staff can always be on the same page when delivering care.
Revenue Leakage/Charge Capture:
Leverage charge capture systems and services to quickly detect and resolve any costly revenue leakages in your billing process.
Claims Submission:
Build end-to-end claims submission processing strategies to deliver clarity and efficiency.
Payment and Rejection Processing:
Improve remittance processing turnaround times for payment and rejection processing to reduce costs and improve staff productivity.
RAC and Other Denial and Appeal Management:
Reduce your time spent on resolving denied claims and appeals to boost your claims rate and revenue.
Third Party Follow-Up:
Boost staff productivity and profitability by outsourcing communications and followups with third parties for claims processing, accounts receivables, and more.
Financial Counseling:
Offer financial education to make medical billing and insurance clearer for patients so that you’re advocating for their best interest and removing potential “sticker shock.”
Unbilled Management Medicaid Advocacy:
Understand the implications of unbilled services on your revenue cycle and educate your team on how to navigate them.
Contract Negotiation Support:
Leverage effective negotiation strategies to maximize your return and best advocate for your organization, employees, and patients.
Who We Serve
What's on Your Mind?
Steven Bisciello
Steven Bisciello is a Health Care Services Group, Partner experienced in revenue enhancement programs, health care litigation, compliance and physician practice management.
Start a conversation with Steven
Health Care Insights
Curated content related to current Healthcare issues and how we can help provide guidance.
