Today’s era of healthcare reform demands new levels of collaboration to improve revenue cycle performance. At a time when change has become a perpetual mainstay, one thing has remained consistent – the need to maximize revenue while maintaining exceptional levels of care quality and patient satisfaction. In partnership with our team at Navigant Cymetrix, we help hospitals, health systems and physician practices improve performance, reduce costs to collect, and achieve sustained results with solutions tailored to each client. Our team of experienced healthcare experts benchmark key performance indicators, and help providers streamline processes, drive performance improvement, and manage change.
An effective revenue management program must promote accurate and timely capture of patient revenue, including rapid resolution of pending revenue, while providing a forum for communication and escalation of charge entry or other charging related issues. Doing so can help hospitals and health systems:
- Reduce variability in gross revenue capture
- Improve visibility around charging issues and opportunities
- Increase accountability around gross revenue capture and understanding across the organization
- Reduce late, missing and/or inaccurate charges
- Minimize denials and write-offs
- Improve net revenue capture
Revenue Cycle Management Solutions - Hospitals and Health Systems
Combine and tailor individual solutions to meet your performance goals.
Net Revenue Improvement
The core mission within our revenue cycle management solution model is to improve client’s revenue cycle processes and net revenue yield by leveraging electronic medical record (EMR) technology and best-practice operational strategies. By leveraging our industry expertise, strategic partnerships, and technology, we drive financial improvement and operational excellence positioning our clients to deliver the highest quality of care. We deliver lasting, impactful results through our culture of continuous collaboration and willingness to challenge ourselves and our clients to improve the overall financial sustainability of healthcare.
System Conversion and System Integration Management
An electronic health record (EHR) is much more than a clinical tool – it also automates part of the revenue cycle. EHRs contain all of the touchpoints and data elements to ensure payment, including registration, insurance eligibility, authorization, revenue capture, coding and claim scrubbing. With an effective EHR system, as a clinician documents care that’s delivered, charge capture takes place automatically in the background. This can allow for:
- Application of diagnoses for rapid claim generation with minimal back-end review and clinician follow-up
- Automation of payer specific claim manipulations to reduce scrubber errors and denials
- Automatic (instead of manual) processing and review of late charges
- Routing of denials to departments causing the error, improving front-end education opportunities by driving accountability
Developing a high-performing revenue integrity (RI) department is likely to be one of a health system’s most important revenue management efforts, especially during an EHR transition and into the shift to value-based reimbursement.
The objective of a RI department is to identify, correct, and optimize the processes and systems that can lead to lost revenue opportunities. This includes ensuring procedures, items, and services are documented, captured, billed, and paid according to the terms of regulators and payers.
Operational Redesign initiatives aim to enhance organizational structure and processes through targeted system and process optimization. With a focus on process redesign and improvement, we lead the conversion of organization structure and staffing, policies and procedures, and billing system workflows. In partnership with our clients, we document operational staffing levels, structure, processes, and workflows to evaluate and provide recommendations for any future state conversion from the current operational structure to a more tailored model. We work closely with our clients to develop best-practice revenue cycle tools, system configuration updates, and supporting processes that coincide with the operational goals of the health system.
Net Revenue Improvement
The core mission within our revenue cycle management solution model is to improve client’s revenue cycle processes and net revenue yield by leveraging EMR technology and best-practice operational strategies. By leveraging our industry expertise, strategic partnerships, and technology, we drive financial improvement and operational excellence positioning our clients to deliver the highest quality of care. We deliver lasting, impactful results through our culture of continuous collaboration and willingness to challenge ourselves and our clients to improve the overall financial sustainability of healthcare.
Revenue Cycle Management Solutions - Physician Practices
Close the gap between care and reimbursement.
Deploying a high-performing revenue management program continues to be a necessity for providers to survive and thrive during healthcare’s transformation. As a leading comprehensive revenue cycle management solutions provider, Navigant’s subsidiary, Navigant Cymetrix, is recognized with industry accolades such as the 2017 KLAS Category Leader Award for revenue cycle outsourcing, as well as the 2015/2016, 2013, and 2012 Best in KLAS Award for extended business office services. Navigant Cymetrix is also one of only five firms recognized as MAP Keys Compliant by the Healthcare Financial Management Association
Learn more about Navigant Cymetrix.