Revenue Cycle Management

Eagle Consulting assists with a comprehensive review of the entire revenue cycle, identify any problem areas, and provide the expertise, training, automated tools, and coaching necessary to help you maximize your revenue.

Managing revenue is critical to the financial health of the medical practice, and is a job which has become enormously complicated.   Engagements typically begin with a diagnosis of the problem areas.  Potential solutions include accurate patient registration, eligibility verification, securing pre-authorization, proper coding and documentation, real-time electronic claim submission and co-pay collection, automatic remittance posting, automated claims appeals,  and implementing effective reporting and follow-up.

The recent trend of high-deductible insurance plans have obsoleted the long-established procedures for certain medical specialties.  Practices who redesign their revenue cycle to submit certain claims at time of service can improve cash flow by enhancing collections from the patient.

Practices consistently request assistance in the area of Billing and coding.  A billing and coding engagement typically involves a chart review of 5 to 10 charts from each clinician on the staff.  A trained and certified coder evaluates these charts and compares them to the billing records.  A customized on-site training program is delivered based on the results of the audit to highlight for the physicians and staff any areas for improvement.  A written compliance plan, consistent with guidelines from the Office of the Inspector General, will also be created.  After helping you become compliant, our team will help you stay compliant — which will reduce your stress.  During this process, our consultants are always looking for  opportunities to achieve additional practice revenue through accurate coding and documenting the work which is already performed.

While billing and coding are common problem areas, the best financial results are only possible with attention to the entire revenue cycle.  Very often it is the initial steps taken with the first patient encounter which prove to be important to avoid later problems.  An effective financial policy, agreed in writing by the patient, is the foundation.  Securing accurate information at the beginning of the patient relationship, and having reinforcing the financial policy with conversation by the staff will allow for accurate billing to the proper 3rd party payer.

Other problem areas arise from the mechanics of billing, with attention to the different requirements of every 3rd party payer.  Effective use of computer systems plays a vital role in this process.  Eagle can help with staff training and a continuing education program to keep your staff up-to-speed on the constantly changing billing procedures.

As the AMA Payer Report Cards demonstrate, many payers have poor track records in accurate payment.  Automated tools are available to audit payment against the contract, with the capability of generating automated claims appeals.

Effective reporting, combined Staff incentive programs are frequently recommended to align their paycheck with the objectives of the practice.  Eagle can design an incentive program that works for your unique practice situation.

In summary, Eagle Consulting can assist with a comprehensive review of the entire revenue cycle, identify any problem areas, and provide the expertise, training, automated tools, and coaching necessary to help you maximize your revenue.