Healthcare Excellence Institute


Revenue Cycle Cash Leakage Assessment

Independent, Third Party Audit and Analysis

A third party, independent revenue cycle assessment can be a great way to understand where opportunities in a revenue cycle exist. Different opinions often exist within a healthcare organization as to how the revenue cycle is performing. Some might say poorly, some might say great. Now is the opportunity to find out the objective truth. Most revenue cycles are focused on a traditional way of business that is more in tune with exception reports and handling crises than preventing the problems. It is impossible to see the opportunities for prevention when all you can do is handle the problems.

Signs that an assessment would be good for the organization:

  • Every day seems like a fire drill in the revenue cycle
  • You're told that cash as a percent of net is 103%
  • Associates are busier doing rework than actual work
  • Reactive vs. proactive culture
  • Inability to precisely quantify how much cash leakage costs the organization
  • Fears when JCAHO Audits come around
  • Worries about compliance standards
  • Lack of transparency within the revenue cycle
  • Lack of predictability in financial performance
  • Inaccurate A/R
  • Exception reports are the focus
  • Erratic and volatile financial performance
  • No cohesive management system exists to address problems

What's the process for a revenue cycle assessment?

The assessment process involves a detailed operational analysis to determine if additional cash is available to the organization through systemic revenue cycle work. Generally at least 4% more is available and up to 15%. Our operations analysis team does a deep dive into the data while our process team looks at the physical process. Then the two sources are put together to quantify the improvement that would be expected from fixing the processes and preventing the errors using multi-variate analysis techniques. The assessment delivers:

  • One-time ScoreLogix report
    • Analysis of a minimum of two years worth of encounter data
    • Quantification of Patient Access (PA), Health Information Management (HIM), Patient Financial Services (PFS), and Case Management (CM) performance
    • Evaluation of financial performance trends and volatility
    • Direct benchmark comparison to our HFMA MAP Award Winning Customers
    • Direct benchmark to the best revenue cycles
  • On-site process observation of the following areas:
  • Detailed account audit includes observation of:
    • Account Activity
    • Account Quality
    • Compliance Issues
    • Late Adjustments
    • Account Notation
    • Proper Cash Posting
    • Inventory Penetration
  • Quantified monthly cash leakage by payer
  • Detailed revenue cycle assessment report, presented in-person

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