Revenue Management Optimization

RCA assists providers in re-engineering revenue management processes through a multi-step process:

• A preliminary diagnostic appraisal in the form of a quantitative, transactional-supported organizational Revenue Management Assessment and Evaluation.
• Delivery of an Executive Briefing that provides a business plan that defines the size and composition of revenue management staff as well as a budgetary forecast with projected ROI.
• Human Resource assistance: RCA provides all job descriptions and then assists with recruiting, screening and co- interviewing of candidates.
• Facility planning and on-site implementation.
• Continuing long-term support and guidance with Best Practice focus.

Revenue and Cash Discovery

Utilizing our sophisticated, proprietary software edits, RCA can find hundreds of thousands of Dirhams for our typical clients.

Areas of focus include:

• Medical Education add-on billing for teaching facilities
• Policy number & insurance information for:
  • Self pay open balance accounts
  • Zero balance accounts (Bad debt & charity care)
  • Secondary billing
• Inpatient retrospective DRG changes
• Ambulatory surgery billing opportunities
• Discharge Disposition error billing opportunities
• Radiation and Chemotherapy billing opportunities
• Un-posted, billable charges
• Inpatient Time of Admission billing opportunities
• “Silent PPO” reviews
• Outlier Reviews
• DRG Add-ons
• I&R counts

In addition, our clinical and financial experts provide outsourcing solutions related to cost report preparation, clinical appeals, DRG validation, third party cost outlier reviews and denial responses, and Medicare Recovery Audit Contractor (RAC) denials. We also offer specific consulting services related to strategic pricing, transparent pricing, and chargemaster reviews.

Benefits of Using MEHIM Revenue Cycle Analytics

Knowledge dissemination and targeted solutions all of our projects provide objective, data driven ideas for recurring revenue.

• Share specific findings with you
• Pinpoint sources of lost revenue
• Diagnose system setup issues and offer solutions
• Determine process breakdowns and recommend improvements

Rapid Results

Our clients are amazed at the speed in which RCA produces revenue and cash results. Upon receipt of data from our straight-forward data request, we can generate billable findings for your review in a matter of days! Due to the strict time limitations of third party payers for corrected billings, RCA provides extra speed to identify those missed billing opportunities and re-submit before those $$$ are lost forever.

Unobtrusive Approach

Our leadership team has decades of provider healthcare experience and knows what it's like when the consultants come with their requests for information. Our request is simple: provide us with a straightforward predefined data file that requires minimal or no programming resources and we will utilize our proprietary database and edits to search for value. We may also ask for remote “view-only” access to your billing system or for an on-site terminal for a few days to ensure data validity, and we will utilize our proprietary database and edits to search for value.

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