Account Review & Analysis

Uncovering the strengths and weaknesses of your revenue cycle management operations.

Our account review and analysis is an examination of all the elements that contribute to your existing revenue cycle. Its purpose is to identify areas of opportunity for improving revenue generation through clinical integrity, strengthening core competencies through staff training, and using information to manage revenue cycle operations.

 

Enhance team performance

We look at each function in your revenue cycle management process to determine how it helps or hinders revenue generation. Our specialists will evaluate each function within your revenue cycle management (RCM) operations and learn your current processes in order to provide feedback and enhance your overall team performance.

Account reviews also evaluate insurance reimbursement trends for the following measures and demonstrate how they explain revenue cycles:

  • Production rates: number of claims/dates of service billed versus paid/adjudicated
  • Capture rates: percentage of paid to billed
  • Average allowable amounts by payer
  • Payer mix of aging receivables
  • Monthly collection composition

 

 

Understand drivers of performance for your facility

Determining if and when your facility would benefit from an account review and analysis is difficult. However, you don’t want to wait until it’s too late. Primary indicators of the need for an account review and analysis include:

  • Untimely verification of benefits
  • Decreasing trends in authorization obtainment
  • Increasing receivables in the 90-day aging period
  • Increasing denials
  • Unsuccessful appeals processing
  • Delayed payments
  • Insufficient or inaccurate reporting and analytics

 

Improve efficiency with insurers

Our team will provide you with the information necessary to minimize delays in your interactions with insurers such as:

  • National Provider Identifier numbers for both in or out of network, as required by all payers
  • Listing with insurance carriers to establish your facility with major carriers
  • Customized insurance forms for your facility to meet the requirements of insurance providers

 

ICOTP
NAATP Member
AMBA
HBMA
ATAC

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Case Study: Crownview Medical Group

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