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The ChallengeImage

Due to the nature of the hospital industry, there are extreme challenges in recruiting and retaining skilled managers and other related staff. The Business Office and Patient Account Managers must know the most recent regulatory requirements and the industry’s best practices in order to efficiently manage the accounts receivables.  In addition, coordination of vital and necessary communications through out the entire spectrum of the revenue cycle is critical to the success of the departmental goals and objectives. In some cases this struggle is magnified more, due to the hospital size, geographic location and or limited budgetary resources. Insurance delays in processing, systematic barriers and or limitations are additional issues demanding attention. Administrative demands to meet cash goals and the overall status of the accounts receivable increases the amount of challenges that must be address with satisfying results.

Our Approach to the Solution

PF Concepts has a service that elevates the quality of the Patient Access and Patient Account processes and their produced results.  This valuable resource can be provided at very affordable and negotiable fee with a guaranteed return on investment. The Operational Assessment, with an inter-related Plan of Action, combined with the mentoring of key personnel has proven to be the most essential benefits of this process.  PF Concepts through all of the existing programs and specifically, the “Mentorship and Training Program” excels in equipping the hospital’s employees and grooming them to become a valuable asset and team leader to the hospital organization.  We accomplish this objective by:

  • Understanding and incorporating senior management concerns into the established program objectives
  • On the job training by senior PF Concepts’ Specialists
  • Creation of applicable indices and benchmarks including:
  • Aging Analysis by Payer
  • Discharged, Not Final Billed Receivables
  • Late Charge Postings by Service Area
  • Days Delayed;  Discharged to Final Billed
  • Time line from Billing to Follow-Up
  • Claim Denial Volumes/ Amounts /Types
  • Credit Balance Levels
  • Bad Debt / Bad Debt Recovery Levels
  • Cash Collection to Net Revenue Ratio
  • Cost to Collect
  • Detailed analysis and documentation of improvements all significant revenue cycle processes
  • Strong focus on issues relating to compliance with HIPAA privacy regulations   
  • Timely claim submission and follow up to account completion
  • Detailed and serviceable management report

Typical improvements include:

  • Increases in accuracy of demographic and financial account information
  • Faster turn around in verification and processing of critical account information
  • Shortened timeframe from discharge to final bill
  • Reduction  of claim denials
  • Reduced Aged Receivables days
  • Lower bad debt and charity write-offs
  • Increases in cash flow
  • Increases in general patient related satisfaction
  • Improvements in staff moral and a lower employee turn around rate
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