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CPI Experts - Services

Revenue Cycle Advantage™

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Despite more than a decade to get it right with the UB-92 form, the healthcare industry continued to fumble right up until the end.  Now, the need to implement several key changes to federally-mandated billing processes threatens to de-stabilize healthcare organizations that are already stretched to the breaking point.  How well has your organization implemented the new UB-04, including the NPI and POA requirements?  Have you accurately implemented all additions, deletions and modifications to the revenue cycle to ensure that you are now receiving the payments to which you’re entitled?

CPI Experts is armed with the knowledge and experience to take recently-enacted revenue cycle regulations from memorandum to mobilization.  Our Revenue Cycle Advantage™ is designed to address the complexity that occurs when detailed code and field changes are applied to the intricate processes of the revenue system.  We will review data capture, design, integration, forms, and transactions to ensure that your organization is not only compliant with new requirements but also maintaining the accuracy that contributes to entitled net revenue realization.

Revenue Cycle Advantage involves a comprehensive work-up of all processes that affect revenue realization, following the contour of data flow through all essential transactions.  Our goal is your goal:  to ensure the integrity of transactions that drive and help realize revenue.

Revenue Cycle Advantage™
ARRANGE CARE PROVIDE CARE FINANCE CARE

Scheduling

Scheduling process

Patient insurance data
 

Charge Capture

Review/update CDM Pricing strategy

Review charge capture

Process improvement

Billing

EDI editing and billing

Late charges

Reduce DNFB

Medicare billing edits

Registration/
Admission

Pre-registration

POS Collection

Insurance verification

Denial management

ABN Compliance

Coding and Compliance

Clinical
documentation

Outpatient documentation

HIM and interface issues

Staff competency/
training

Process redesign

Collection/
Follow-up

Work queues

Cash acceleration

Write-off processes

Use of outsourcing

Contract management

Electronic posting

Internal cash controls

Remits/
correspondence

Financial
Counseling

Operations with ED

ID Medicaid eligibility

Cross training

Denial
Management

Case management

Tracking denials/appeals

Appeals processing

Authorization/referrals

Physician alignment

Customer
Service

Staff utilization

Scripting

MD communication

Board relations

Tracking and Monitoring for Quality and Productivity

  • Develop management reports/dashboards
  • Staff organization and training
  • Create performance indicators to monitor goals

Implement ongoing management and monitoring process