Article | March 22, 2022

Revenue Cycle Improvement

The Challenge: Making the Revenue Cycle Perform

The Revenue Cycle is a people and software driven process with many changes and responsive parts. Kohler HealthCare Consulting’s Revenue Cycle Services are designed around your needs. We want to partner with you in traversing the effects of this uncertain economy by offering the following services:

Front End Services

  • Align Case Management/Utilzation Review to Revenue
    Cycle Issues.
  • Front End Assessment and Implementation Based on
    Specific Departmental Issues.
  • Education Services—Educate departmental staff on
    documentation and proper charging.
  • Perform Overall Compliance Reviews.

Middle Services

  • Charge Master Integrity—Update the Charge Description Master (CDM) and Charge Capture Elements and Functions (both how and what). Assure departmental staff understand what to select. Also, confirm Physician Orders are in place and followed with supporting documentation.
  • Coding Audits for Charging Accuracy.
  • Compliance Audits.
  • Physician Education Services—Complete orders and documentation to support charging.

Back End Services

  • Denial Prevention—Assure services are captured as well as demographic/insurance information to reduce denied claims or MAC/RAC paybacks. Identify functionality of Patient Financial Services for improvements and Leaness.
  • Denial Processing—Evaluate and improve denied days and services—circle back to Care Management on denials and appeals. Root cause analysis.
  • Determination of System Issues and Resolution.

Kohler HealthCare Consulting is known for implementing what we recommend. We want you to have the options to use the tools you have in place and we can help verify they are being used to their highest capability. Or, we can help you select the tools you need. KHC is committed to your future successes.