Optimize The Clinical Revenue Cycle

Hospitals across the country continue to face economic challenges. While some hospitals have improved their margins, financial health is still at risk. Shifting care to lower cost outpatient areas is one strategy, however, not every organization is in a position to make that pivot.

Focusing on the Clinical Revenue Cycle may be one strategy that can provide a means to ensure your hospital is receiving reimbursement for the services provided. Here are three key areas that provide a quick return:

Patient Status

o   Patient must be placed in the correct status, i.e., inpatient verses outpatient.

o    Physician documentation must support the status

Concurrent appeals process

o   Robust processes must be in place to track, monitor and manage continued stay denials

Denial mitigation strategies

o   Identify early opportunities to address front end gaps in the Utilization Review workflow

o   Create a formal process to communicate back-end denial information in an effort to close gaps in process workflows on the front end

Through our engagements, we partner with clients to breakdown silos and integrate physician champions, utilization review nurses, analysts, IT architects and executive leaders. Our partnership model assists organizations in improving both administrative, clinical practice and technology workflows. Our teams at Impact Advisors work tirelessly to assist hospitals in rapidly tackling these key areas. Message me to learn more!

About Lisa M. Bragg: Lisa serves as Managing Director at Impact Advisors. She is the national leader for clinical optimization and care transformation. Lisa and her team of clinicians have helped organizations secure the reimbursement for services that would have otherwise been lost due to misinterpretation of guidelines and failed IT and process workflow.