Healthcare Advisory Services

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.

REVENUE CYCLE ASSESSMENT

Whether you have had a change in leadership, system conversion or a slow-down in cash, Withum offers various assessment options:

Targeted Functional Area Assessment
A focused review on a specific area 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.

Comprehensive Assessment
A healthcare providers 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.

Revenue Leakage Assessment
Rapid assessment identifying revenue leakage opportunities throughout all functional areas within the Revenue Cycle.

REVENUE CYCLE SERVICES

Retrospective Denial Analysis/Root Cause Identification/Denial Prevention
Denials unfortunately 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.

Retrospective Revenue Recovery
Contractual disputes, inappropriate payment and coding & billing errors all lead to opportunities to recover revenue. Our team will collaborate with payors and Medicare to recover historical revenue going back up to four years.

Financial Assistance Policy (FAP) Review
Regulatory changes from the Internal Revenue Service and CMS require a more comprehensive FAP. Our review ensures compliance with the Internal Revenue Code 501r, in addition to ensuring the FAP includes the appropriate language to capture uncompensated care through the Worksheet S-10.

Interim Management
Change in staffing, leave of absences and upcoming conversions all present opportunities for an interim management resource. Our team works seamlessly with yours to ensure your Revenue Cycle is effectively managed during this time of transition.

Physician Practice Compliance
According to the Office of the Inspector General (OIG), 42% of Medicare Claims billed for E & M services are incorrectly coded. Validation of coding and physician documentation minimizes physician practice risk regardless of your size. The OIG recommends at least annual reviews to ensure compliance.

 Services Offered:

• Review and Development of a Compliance Program
• Baseline and Expanded Auditing
• Training and Education
• Corrective action plans

Contact us today to talk about optimizing your organization’s revenue potential with a complimentary consultation with a healthcare advisory specialist.