We uncover critical inefficiencies and areas of revenue leakage within the revenue cycle.
These may range from inadequate prior authorization practices to suboptimal patient eligibility verifications that lead to denials.
Addressing these issues boosts revenue and enhances overall compliance and operational efficiency.
What You Get
Comprehensive Audit Report
A detailed report summarizing the findings from the audit, which highlights key performance metrics, identifies compliance risks, and pinpoints inefficiencies within your RCM processes.
Actionable Recommendations
A prioritized list of tailored actions based on the audit findings to rectify identified issues. These recommendations focus on improving efficiency, ensuring compliance, and optimizing revenue outcomes.
Facilitated Review Session
A structured discussion with your billing team or service provider to review the audit findings and develop a corrective action plan.
Continuous Monitoring Strategy
Recommendations for ongoing monitoring of billing processes to ensure sustained improvements and compliance.
What We Do
Full-Scope Billing and Revenue Cycle Audit
This extends the Medical Billing review to include all facets of RCM, providing a holistic assessment.
Prior Authorization Process Review
Calculating the authorization failure rate and examining lapses in obtaining or using incorrect authorization codes.
Eligibility and Benefits Verification
Analysis of patient eligibility, denials due to eligibility issues, and accuracy of in-network contracting.
Patient Estimate and Collection Analysis
Assess billing practices before and after service delivery, the accuracy of estimated collections, and the handling of Advanced Beneficiary Notices.
Referral Management Evaluation
This involves analyzing referral acquisition, management, and the impact of improper referrals on denial rates.
Why You Need This
In today's complex healthcare environment, a robust and efficient revenue cycle is crucial to the financial health of your medical practice.
Recognizing the multifaceted nature of revenue cycle management (RCM), our Comprehensive Revenue Cycle Audit delves into each cycle segment, from patient intake to final payment.
This service is designed for practices looking to gauge the effectiveness of their billing practices and refine and enhance the entire revenue management strategy, ensuring maximum revenue retention and compliance.
