SCALE RCM brings decades of experience building and managing revenue cycle operations of scale. We have developed and refined best practice systems and processes through billing across more than 30 medical specialties as well as numerous sites-of-service and practice management & EHR systems.
We employ both a quantitative and qualitative approach to assessing our partners’ revenue cycle operations. We evaluate current performance across the end-to-end process including provider credentialing, patient booking and benefits verification & authorization, date-of-service registration and documentation, the full scope of back-end processes through full claim adjudication, and on-going department oversight and reporting.
Assess Your Current Billing Program
- What is your current revenue cycle department organizational structure? Is the optimal team in place?
- Which functions are best centralized versus handled at individual practice locations?
- Is performance being measured quantitatively within each function and what are the target performance benchmarks?
- Which functions can be effectively automated? Do the current technology systems offer full best practice functionality?
- What processes and strategies have been implemented that restrict performance scalability?
- How does the revenue cycle team communicate with other departments tangentially involved in the revenue cycle process – e.g., operations, scheduling, finance, payor contracting?
STEP 1: Initial audit
Initial audit of current revenue cycle department organizational structure and functions.
STEP 2: Develop a roadmap
Develop a roadmap to deliver tangible value add analysis, insight, and recommendations across each revenue cycle function.
STEP 3: Provide ongoing support
Provide ongoing support of your revenue cycle team to implement roadmap as well as identify and realize on-going performance improvement opportunities.
STEP 4: Report executive findings
Report clean executive summary focused on key performance metrics across the full range of revenue cycle functions and empower your revenue cycle team, executive leadership, and Board to pursue on-going performance improvement.
STEP 5: Track achievement
Track achievement of tangible improvements in your revenue cycle compliance, realized collections, and stakeholder satisfaction.
We discovered significant gaps in our Client’s billing department through our initial audit. Our Client did not have a full-time billing team, they received a high number of patient complaints with regards to billing, and they were far behind in provider credentialing.
Our billing team streamlined patient billing practices, took over collections on significantly aged claims, and formalized claim submission rules engine to reduce their denial rate.
Our client saw a 10% revenue uplift effective immediately upon our engagement. Our client collected over $100K in aged AR that had been denied and mis-billed in the first month of work and saw $100K of additional revenue per year from services being provided and not coded for.
Bobby is the President of SCALE RCM. He served as President of CSI Medical Billing for the over 14 years. Bobby has achieved mastery of billing for over 30 specialties, practice management systems and EHRs.