Strengthening Revenue Cycle Performance: Aligning Internal Teams and External Partners to Drive Financial Performance

Revenue cycle performance is rarely a billing issue alone. Whether managed internally or through an outsourced partner, sustained improvement requires active leadership alignment, clear accountability, and consistent oversight.

In rural hospitals, breakdowns in documentation, charge capture, coding accuracy, patient access, denial management, and vendor communication often stem from unclear ownership across clinical, operational, financial, and external partners.

This session explores how leadership alignment — supported by clearly defined revenue cycle champions and governance structures — directly impacts cash collections, days in accounts receivable, denial rates, and overall financial stability.

Through a panel discussion, including a CAH CFO, attendees will examine how organizations successfully manage revenue cycle performance across different operating models, including fully outsourced environments. The discussion will highlight practical approaches to setting expectations, monitoring vendor performance, aligning clinical teams, and creating shared accountability for financial outcomes.

Participants will leave with a framework for elevating revenue cycle from a back-office function to a strategic leadership priority — strengthening financial performance without adding unnecessary complexity.

At the end of this session, participants will be able to:

  • Explain how leadership alignment impacts revenue cycle performance across both internal and outsourced models.
  • Design a governance structure that establishes clear accountability for revenue cycle outcomes, including vendor oversight where applicable.
  • Implement practical strategies to align clinical, operational, and financial teams around shared revenue cycle goals, improving cash collections and financial stability.
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Q&A

How do people stay on top of all the payer newsletters to sort through everything to pull out applicable information for the facility/provider? Who typically is going through the newsletter to gather the information to share with other staff?

Our billing specialists are organized by payer, allowing them to develop deep expertise in their respective areas. Each specialist subscribes to their payer’s newsletters to stay informed about updates and changes. Additionally, our team leads, Supervisor, and Director of Patient Accounts—along with the Prior Authorization Team—collaborate to share key insights and ensure the entire team stays up to date. This collective approach enhances our ability to navigate payer policies efficiently and provide the best possible service. 

What leadership structure do you have in place for your revenue cycle and who or what do you use for training when billers or coders need it? Especially for new service lines or common denials?

Our billing specialists are supported by a structured leadership team, including two team leads, one Supervisor, and one Director. Training for billing specialists is conducted by our Supervisor and team leads to ensure consistency and expertise. Additionally, billing specialists meet weekly with leadership to review denials and identify payer-specific trends. For new coders, who are required to be certified, training is led by our Coding Lead to maintain high standards of accuracy and compliance.

Are the billers assigned based on an alphabetical split or by insurance type, such as Medicare and Medicaid specialists?

Billers are first assigned by insurance type and then further divided by alphabetical split. Since each insurance type has multiple billers, the alpha split helps distribute the workload efficiently.

Since we have union employees, how could we implement a similar incentive to Kindal’s while ensuring compliance with union regulations?

This would depend on the specifics of your union contract. Stroudwater can work with you to review the contract and develop a compliant incentive model.

Does your Coding/HIM department manage CPT coding, modifiers, and ICD-10, or do they focus solely on ICD-10?

Our Coding team handles all aspects of coding, including CPT, modifiers, and ICD-10. They thoroughly review all provider documentation to ensure accuracy and compliance.