Case study: Revenue cycle assessment finds revenue leakage for health system
Advisors help a health system locate and mitigate revenue leakage, potentially saving millions of dollars.
A for-profit, five-hospital corporate health system based in the Midwest.
The situation
The healthcare system had purchased three financially distressed hospitals in the Midwest. The client’s mission was to turn around the hospitals’ overall financials. The firm was engaged to identify opportunities in the revenue cycle to evaluate their account receivables (AR), improve their cash collections, and help minimize revenue leakage.
The solution and results
The firm was able to complete a full-scope operational revenue cycle assessment including patient access, medical records, billing and collections, and account resolution.
As a result, the firm was able to identify over $18.2 million in current AR that was not being collected, increasing net revenue. On top of that, the firm made recommendations for ongoing future annual increases that were estimated to yield an additional $5 million–$6 million.
In addition, the firm worked to apply system analytics to pinpoint operational deficiencies and cash collections opportunities. The firm provided work lists for areas of concentration and prioritized accounts for resolution activity. Recommendations were also provided to remediate issues such as authorizations not obtained for services or treatments, unbilled claims, health information management coding errors, underpayments from payers, and appealing denials.
The firm helped this organization with a thorough deep dive assessing their revenue cycle operations and providing guidance to improve cash collections.