As healthcare continues to evolve from fee for service to value based, our mission here at Withum is to provide Revenue Cycle Services that will ensure our providers Revenue Cycle continuum is aligned to realize full revenue potential. Our expertise works collaboratively with you as an extension of your team to identify and implement process improvement opportunities and initiatives that will improve your overall revenue.
Whether you have had a change in leadership, system conversion or a slow-down in cash, Withum offers various revenue cycle and revenue recovery services including:
Denials impact the ability to realize full revenue potential. Effectively managing “true” historical denials data, identifying the root cause issues and resolving the disconnect to prevent reoccurrence in the future can be challenging for providers. Our comprehensive denials management approach assesses historical denial trends while collaborating with you to prevent future denials.
Contractual disputes, inappropriate payment and coding and billing errors all lead to opportunities to recover revenue. Our team will collaborate with payors and Medicare to recover historical revenue for up to four years.
Withum recognizes that with significant cashflow interruption, medical centers are viable candidates for our retrospective billing analysis.
Centers for Medicare and Medicaid (CMS) reimburses hospitals add-on payments over and above the Diagnosis-Related Team reimbursement for blood clotting factors and other new technologies. These payments are facilitated by coding and billing criteria but disconnects can result in lost revenue for providers. With recent increases in technology reimbursement, hospitals must ensure they are properly reimbursed. We will review Medicare claims that were incorrectly billed and recover funds to maintain positive margins for your organization.
Utilizing an interim resource allows healthcare providers an opportunity to recruit for their optimal leader. There are also opportunities to work collaboratively with an internal resource who may need short-term mentorship to step into a top leadership role. Withum’s professionals have spent their careers working collaboratively with providers in interim roles to ensure cash flow remains constant and internal goals and initiatives are achieved as planned.
A focused review of specific areas within the Revenue Cycle continuum, such as Scheduling, Insurance Eligibility, Charity Care Point of Service Collections, Case Management, HIM, Observation, Charge Capture, Billing, Aged Receivable Analysis, Vendor Management, and Bad Debt.
A healthcare provider’s revenue cycle contains countless processes integrated across your people and systems. A full comprehensive assessment of each functional area within the Revenue Cycle, providing a roadmap and workplan for new and existing leadership, that will identify key areas of opportunity and efficiency. We customize your review based on your priorities and business needs.
Rapid assessment identifying revenue leakage opportunities throughout all functional areas within the Revenue Cycle.
For FQHCs, audits under Uniform Guidance, also known as single audits, often generate many questions and can potentially result in impactful findings. Early preparation and recurring attention can save time and help mitigate compliance issues. Section 330 grants, HRSA supplements and pass-through awards may all qualify as federal expenditures under 2 CFR Part 200. With…
As a partner and leader within the Firm’s Healthcare and Not-For-Profit Services Teams, James serves healthcare organizations, not-for-profit entities, educational institutions and recipients of governmental funding. He specializes in providing audit services to complex healthcare and nonprofit organizations, helping leadership teams strengthen internal controls, improve operational efficiency and make informed business decisions. James works closely…
On January 20, 2026, the Internal Revenue Service (IRS) resumed accepting new applications for group exemption ruling requests by issuing Revenue Procedure (Rev. Proc.) 2026-8. This new guidance ends the moratorium on new applications for group exemption rulings that began in 2020 and introduces new requirements and guidance for applying for and maintaining a group…
Aligning provider compensation with performance isn’t just smart; it’s essential in healthcare. Our free Provider Compensation and Performance Health Check assessment delivers a comprehensive review tailored to your organization’s needs.
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