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Revenue Cycle Management (RCM) & Optimization

Providing actionable insights into current revenue cycle operations in order to correct problem areas, improve productivity, reduce costs and increase revenue.

Revenue Cycle Management (RCM) & Optimization

Baker Tilly’s wide range of revenue cycle management (RCM) solutions help healthcare providers of all sizes grow net revenue, increase cash collections, improve employee productivity, optimize existing EMR systems, and help organizations remain as competitive as possible.

Whether you need assistance assessing your organization’s current RCM performance, improving select operational areas, or undergoing a complete transformation, our team of specialists are here to help.

By taking advantage of process level data and combining it with Baker Tilly’s experience and proprietary set of tools, we can help management teams better understand their revenue cycle performance – identifying root causes quickly so that corrective action can be taken early and reduce and eliminate potentially large drains on annual revenues.

Whether it’s evaluating a particular subset of your revenue cycle process or your entire operations, our team will identify gaps and actions needed to achieve real results. Our process includes:

  • gathering and analyzing data
  • conducting on-site interviews
  • observing key processes
  • measuring payment accuracy
  • creating a roadmap for quick wins and long-term improvements

The RCM process has many facets, and we realize most organizations do not need a full-scale revenue cycle transformation improvement. Because of this, our team can work with you to help correct and optimize areas where corrective action is most needed, including the pre-arrival, arrival, service integrity and documentation, and post-care and financial services RCM stages.

Managing traditional payer and value-based contracts

Successfully setting up, negotiating and managing contracts with payers is a key component of revenue optimization. From ensuring contracts are meeting industry benchmarks to managing contracts to ensure you are getting paid established rates to negotiating traditional fee-for-service (FFS) and innovative value-based care (VBC) contracts, our team is here to help.

Streamlining processes and automating repetitive tasks

Steps taken within the RCM process can often be tedious, repetitive and prone to human error. With Baker Tilly’s depth and wide range of skillsets, we can identify inefficiencies, create best practices and implement consistent processes throughout the RCM process.

In addition to changing basic workflows, our team can help streamline complex processes and automate mundane tasks with robotic process automation (RPA) and automation intelligence (AI). With this combination, our team can help increase employee productivity so that more time can be spent on higher value-added tasks, eliminate human error, and more easily identify alerts that can help reduce dials, recognize and manage underpayments, reduce A/R turnover ratios and more.

Optimizing existing EMR systems

Because medical records are fundamental to every aspect of healthcare, it is necessary to understand how they are used within an organization. Baker Tilly understands how processes and systems work together and incorporates your existing electronic medical records (EMR) system into the planning process to improve workflows and documentation capture to make sure your system is operating as efficiently as possible, including:

  • performing a readiness assessment of current workflows
  • completing interviews to establish future workflow needs
  • providing an analytical review and GAP analysis of these workflows
  • developing and providing training for hospital staff
  • participating in testing, training and go-live activities
  • performing post go-live optimizations

FTE performance monitoring

It is important for providers and management teams to understand the effectiveness of their full-time employees (FTE). Tracking of FTE performance can also enhance individual performance, improve employee morale and lead to greater commitment and longer retention for FTEs, even in a work-from-home (WFH) environment.

With Baker Tilly’s proprietary software, we are able to help your organization have better visibility into FTE performance. This includes insights and metrics to benchmark employees for improved operational outcomes, and insights into how to address negative performance.

With a large-scale RCM transformation, our team can conduct diagnostic reviews of key revenue cycle functional areas driven by data analysis and on-site interviews. We also document conceptual future state performance based on Baker Tilly experience with best-in-class operations and develop initial opportunities for operational and financial improvement. We also compare managed care contracts to determine appropriate benchmarks, payer payment accuracies and denial trends.

After our diagnostic stage, we execute upon mutually agreeable quick win improvements and develop a detailed plan to resolve the systemic issues previously identified. We then start the larger transformation process – which depends on findings from the evaluation stage – and begin executing process and organizational transformation along with optimization of existing technology.

After completion, we also develop a strategic roadmap to help drive long-term accountability and sustainability through our monitoring services that provide dedicated and experienced “preventative maintenance” for your revenue cycle operations.