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Revenue Cycle Advantage™

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Despite more than a decade to get it right with the UB-92 form, the healthcare industry continued to fumble right up until the end.  Now, the need to implement several key changes to federally-mandated billing processes threatens to de-stabilize healthcare organizations that are already stretched to the breaking point.  How well has your organization implemented the new UB-04, including the NPI and POA requirements?  Have you accurately implemented all additions, deletions and modifications to the revenue cycle to ensure that you are now receiving the payments to which you’re entitled?

CPI Experts is armed with the knowledge and experience to take recently-enacted revenue cycle regulations from memorandum to mobilization.  Our Revenue Cycle Advantage™ is designed to address the complexity that occurs when detailed code and field changes are applied to the intricate processes of the revenue system.  We will review data capture, design, integration, forms, and transactions to ensure that your organization is not only compliant with new requirements but also maintaining the accuracy that contributes to entitled net revenue realization.

Revenue Cycle Advantage involves a comprehensive work-up of all processes that affect revenue realization, following the contour of data flow through all essential transactions.  Our goal is your goal:  to ensure the integrity of transactions that drive and help realize revenue.

Revenue Cycle Advantage™
ARRANGE CARE	PROVIDE CARE	FINANCE CARE
Scheduling Scheduling process Patient insurance data	Charge Capture Review/update CDM Pricing strategy Review charge capture Process improvement	Billing EDI editing and billing Late charges Reduce DNFB Medicare billing edits
Registration/ Admission Pre-registration POS Collection Insurance verification Denial management ABN Compliance	Coding and Compliance Clinical documentation Outpatient documentation HIM and interface issues Staff competency/ training Process redesign	Collection/ Follow-up Work queues Cash acceleration Write-off processes Use of outsourcing Contract management Electronic posting Internal cash controls Remits/ correspondence
Financial Counseling Operations with ED ID Medicaid eligibility Cross training	Denial Management Case management Tracking denials/appeals Appeals processing Authorization/referrals Physician alignment	Customer Service Staff utilization Scripting MD communication Board relations
Tracking and Monitoring for Quality and Productivity Develop management reports/dashboards Staff organization and training Create performance indicators to monitor goals Implement ongoing management and monitoring process

 

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