Hospital Revenue Cycle Performance Management

Build and execute a customized revenue cycle strategy to resolve your hospital’s unique challenges.

CLA can assess your hospital’s revenue cycle performance to help your operations meet key industry performance indicators.

What’s on your mind?

  • Improving outcomes related to performance indicators, such as gross days in accounts receivable (AR), discharged not final billed (DNFB), and point of service (POS) collection rate
  • Increased cost of managing denials
  • Reimbursement shifting to value with an increase in risk-based payments
  • Decreasing margins
  • Modifying your daily operations to implement new technology
  • Net revenue leakage
  • Shifting consumer behavior
  • Implementing and adhering to federal regulations

Create opportunities with CLA

Improving your revenue cycle requires more than a cookie-cutter plan. Because we work with organizations of all sizes, from critical access hospitals to integrated health systems, we understand how CMS and payor rules and regulations may affect your bottom line. Many of our professionals have served as COOs, CFOs, and hospital directors, while others have in-depth technical knowledge of coding, billing, and compliance. With our combined experiences, we can help you work through everything from integrating new technology to mitigating bad debt expenses in AR. Above all, we want you to succeed, so we’ll stay in touch to answer any operational revenue cycle questions that arise after the engagement.

Revenue cycle performance management services for hospitals and health systems

Front-end revenue cycle

  • Patient scheduling, registration, insurance verification and eligibility, POS collection, and pre-authorization operational improvement
  • Patient data integrity management, quality monitoring, and training
  • Education on accurate payor requirements and criteria, medical necessity, and denial prevention

Mid-revenue cycle

  • Charge description master (CDM) services, including defensible pricing and rate rationalization
  • Charge capture (e.g., pharmacy) and revenue integrity
  • Health information management (HIM) operational redesign (e.g., DNFB) and consolidation
  • Clinical documentation integrity (CDI), coding, and billing compliance services
  • 340B drug pricing program services

Back-end revenue cycle

  • Claims management
  • Cash flow acceleration analysis
  • Third-party payor contract review and management
  • Evaluation of denials management process to track accurate and timely reimbursement
  • Follow up and collection oversight
  • AR support and training
  • Business office process improvement