CASE STUDY: Revenue Cycle Department Transformation

February 15, 2022

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Client’s Challenge

Our client’s Revenue Cycle Department was currently undergoing a period of evaluation as to the efficacy and efficiency of its processes. They decided to seek outside assistance with specific knowledge of revenue cycle management and strong leadership skills to help identify, prioritize, and implement solutions.

 

Our Solution

Following an in-depth analysis of the current state of the department, 25 overarching projects were identified as necessary to improve the health of the organization. The active and proposed projects sought to either correct deficiencies within the department itself, or complete standard claims and billing work that had not yet been addressed.

In addition to the overall project and general recommendations delivered to our client, John Lynch & Associates highlighted the most pressing issues that were affecting the Revenue Cycle Management department and provided general recommendations towards resolution.

We identified and provided a full list of current issues to the client. We reviewed the list and prioritized items before implementing. Individual action plans were created and used for implementation and tracking project status.

Several system reports and examples were provided to the client, with detailed descriptions on what needed to be corrected, a recommended plan of action and next steps.

Training for the new resources was created and implemented. Resources were then responsible for monitoring and reporting all RCM related data to C-Suite Executives on a daily, weekly, and monthly basis.

Additional position specific job aides were created to assist the new Manager of Revenue Cycle with the following duties:

• Adjustments Batch Posting Process
• Aging Reports
• Background Business Processor (Client System Specific Functionality Report)
• Claim Production Status
• Claims Submission
• CO16 Denials Processing
• Non-Coordinated SIM / A8 Process
• RCM Throughput Reports
• Tasking Analysis
• Transferring Debits and Credits
• Unbilled Reporting

 

Finally, John Lynch & Associates assisted our client in the screening and hiring of a new Director of Revenue Cycle position. For closure to the project, we transitioned all active projects and supporting documentation to the new Director and appropriate internal department resources.

For more information regarding this case study or if you would like to discuss how we can assist you with your revenue cycle management challenges, please contact us at 623.980.8018 or by email inquiries@johnlynchandassociates.com