Revenue Cycle Optimization

Maximizing Revenue Cycle Management

Increase Profit and Reduce Costs

Effective revenue cycle management is vital to the life of a rural or community hospital, allowing leadership to measure performance, identify trends, note areas of weakness, and sustain or enhance cash flow.

Revenue Cycle Solutions for Rural & Community Hospitals

Stroudwater’s revenue cycle solutions, particularly our focused departmental reviews, have been used successfully by many rural healthcare organizations as the framework for the development of a financial performance improvement plan, to maximize gross revenue and net reimbursement, and to ensure a compliant billing process.

We facilitate the implementation of process improvements with the goal of increasing gross and net reimbursement while ensuring regulatory compliance. We provide specific direction, training, and follow-up to guarantee the successful implementation of opportunities for improvement.

The Stroudwater Associates revenue cycle team is familiar with the revenue cycle nuances of different healthcare organizations.

Our consultants specialize in providing revenue cycle process improvements for a variety of healthcare organizations, including:

Stroudwater’s Specialized Revenue Cycle Solutions Include​

Our coding and chart audit provides an in-depth review of the medical coding processes, helping ensure accuracy and compliance. This is an essential step for revealing discrepancies, optimizing reimbursements, and minimizing risks related to billing inaccuracies or non-compliance.

Our comprehensive chargemaster review rigorously examines the chargemaster to ensure that all pricing and coding are accurate, up-to-date, and compliant with regulatory standards. This meticulous review not only mitigates the risk of revenue leakage but also enhances the accuracy of patient billing, ultimately leading to improved revenue cycle performance.

Phase 1

Our denials management process will review your denial trends to identify the most common reasons for denials and trends related to denials. This will help us to develop a plan to prevent future denials.

As part of that we will review your coding and billing process to ensure that they are compliant with payer requirements and meet industry standards. This will help to reduce the risk of denials and expedite payment.

Finally, our team will provide recommendations for improvement to your denial prevention process and workflow. These recommendations will help you to reduce the volume and severity of denials going forward.

Phase 2

We will review denied claims to determine the underlying reasons for the denial. Our team will also perform an appeal process prioritization analysis, identifying proper resources and methodologies for working outstanding denials.

Phase 3

Our team will develop customized training for your staff on denial prevention and recommend a workflow for denial prevention and management. We will also help develop key performance indicators within the process to track and monitor progress within the denial management area.

Our team can assist in developing the proper key performance indicators (KPIs) for all aspects of your revenue cycle. We can help you identify the right metrics to track, the right cadence to evaluate your data, and the right resources to inform you to make quicker, more informed decisions.
Our payor contracting review and support offers a thorough analysis of existing payor agreements, ensuring they are beneficial and attuned to the healthcare organization’s specific needs. We not only facilitate the negotiation process for optimal contracts but also assist in effective denial management, aiming to maximize revenue and maintain positive relationships with payors while minimizing claim denials.

Our price transparency, shoppable service implementation, and support are designed to assist healthcare organizations in meeting regulatory requirements while delivering clear, accurate pricing information to patients. We help create a comprehensible, consumer-friendly format that promotes ‘shoppable’ services, encouraging patient engagement, and fostering trust in the pricing structure.

Learn More

Our project management support for revenue cycle initiatives provides expert guidance and support to manage and implement revenue cycle projects successfully. By coordinating and streamlining tasks, we ensure that initiatives meet their objectives, drive revenue improvement, and foster operational efficiency within the healthcare organization’s financial ecosystem.
Our revenue cycle key process indicator (KPI) reviews and benchmarking solution provides a comprehensive assessment of the revenue cycle’s performance against industry standards. By identifying areas of strength and potential improvement, we empower healthcare organizations to fine-tune their processes, achieve optimal efficiency, and enhance revenue generation.
Our team can help bridge the gap between your day-to-day revenue cycle functions and your financial goals. Our expertise gives you bench strength within revenue cycle management to lead new revenue cycle management projects, identify high ROI initiatives within revenue cycle management, and oversee day-to-day functions.
Our revenue cycle process reviews include an exhaustive examination of revenue cycle workflows to identify potential bottlenecks, inefficiencies, or areas for improvement. Through this service, we provide actionable insights to optimize processes, leading to increased revenue, improved patient satisfaction, and a more efficient and effective revenue cycle.
Our revenue cycle technology reviews provide a thorough evaluation of the current technology infrastructure and its impact on the revenue cycle performance. We identify gaps and suggest optimal technological solutions to enhance operational efficiency, streamline processes, and maximize revenue potential.
Our No Surprise Act assessment, remediation, and implementation solution helps healthcare organizations navigate and comply with No Surprise Act regulations, minimizing unexpected costs for patients. We assess the current practices, provide remediation strategies, and assist in implementing changes that align with the legislation, promoting patient satisfaction and trust in the billing process.
Our technical assistance and coaching equip the revenue cycle team with the necessary tools and skills to manage financial operations effectively. Stroudwater consultants provide personalized guidance, share industry best practices, and foster a culture of continuous learning to help your team navigate challenges and optimize revenue cycle performance.
Rural and community hospitals and clinics may struggle with proper oversight of their outsourced vendors within revenue cycle management. We can help in creating proper communication channels, effective accountability processes, and even in transitioning/replacing underperforming vendors with more effective ones.
Explore Our Strategic Pricing Tool
Stroudwater’s Strategic Pricing Tool is an online web-based application that helps hospital leaders establish a defensible pricing strategy while eliminating errors and maximizing pricing integrity.

Meet Our Revenue Cycle Leaders

Stroudwater consultants include experienced revenue cycle advisors from diverse backgrounds, including revenue cycle managers, former hospital financial officers, and performance improvement experts. Our holistic, team-based approach to revenue cycle management provides clients with the combined value of our revenue cycle process expertise and the diverse perspectives of the entire firm, resulting in an analysis that examines the revenue cycle from multiple angles while considering the impact these results may have on the entire organization

DBA

Consultant

Revenue Cycle Management

CPA, FHFMA

Senior Consultant

Finance

MBA, CRHCP

Principal

Revenue Cycle Management

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