Revenue Cycle: Increasing Revenue, Decreasing Deficiencies

February 5, 2019

Revenue Cycle:

Increasing Revenue, Decreasing Deficiencies 

Revenue Cycle Systems were the first applications used to help mature the Healthcare Industry, and by the mid to late ’90’s Clinical Systems followed. When EHR vendors started “advertising” integrated enterprise systems, most hospitals already had a Revenue Cycle system in place.

Project Directors and Project Managers alike are seeing a common thread when implementing an enterprise system. Often times during an implementation, the Revenue Cycle doesn’t see the full picture of their workflow from beginning to end.

Excite Health Partners’ VP of EHR Services & Implementation, Todd Klein, has seen this first hand. During an installation of a prominent enterprise system, a presentation from order entry to bill being paid was requested. After two rounds of iterations, the vendor provided the presentation. Todd stepped into a Project Director role after re-testing the system allowing for inconsistencies to be found. The re-test corrected charging issues, resulting in millions of dollars saved. The Emergency Department and Laboratory modules were also big contributors to the improvements.

Excite Health Partners has seen an increase in Revenue Cycle issues among new clients. In the later part of 2018, a client upgraded to the latest enterprise wide system incurring several issues costing them well over $25,000 in revenue on an annual basis. Workflows were not properly thought out and systems were not fully configured or tested.  Underestimating the value of testing can be detrimental.

Often times vendors test the new release with little to no issues at their corporate office. It’s important to note that each facility structure, billing rules and payer plans all contribute significantly to the hospital’s financial system. We offered a Revenue Cycle Project Manager as well as several analysts to help correct the issues our client was facing.

While there are several approaches to ensure the Revenue Cycle quality, it’s vital to use rigger in the testing and to know the workflow. Three important testing areas to focus on are:

  • Charge Testing
  • Parallel Testing
  • End-to-End Integrated Script Testing

On average a hospital can leave at least 1.4 million dollars on the table. Although that estimate will fluctuate based on the source of information, the problem is typically capturing charges or poor documentation. The Emergency Department is one of the largest contributors to this deficiency. By providing “At Risk Revenue Cycle Consulting”, Excite Health Partners is committed to combatting Revenue Cycle issues.

Our services increase revenue where deficiencies exist.  The service starts with an assessment, which identifies the amount of revenue we’ll help you increase.  Afterward, we produce an “At Risk Contract” where we partner with your organization with the goal of increasing your revenue.

When implementing an enterprise system or upgrading to a new release, make sure the system has been thoroughly tested.  If you feel dollars are being left on the table, partner with someone who will share the risks.

Todd Klein

VP EHR Services & Digital Solutions