Case Studies

Physician Revenue Cycle

Revenue Cycle Turn-Around

Hospital-owned primary care practice (200 providers) in Cincinnati with dismal performance:

  • Days in A/R > 100
  • Net Collection Ratio < 80%
  • Bad Debt > 10%

Comprehensive revenue cycle assessment found numerous problems:

  • Un-credentialed / un-contracted providers
  • >$3M in un-collectible bad debt sitting in A/R
  • Un-skilled / un-trained billing staff
  • Dis-integrated legacy PM systems and people
  • Incomplete & improper PM system set-up
  • The list could go on an on - it was the proverbial train wreck

The problems were so severe and the political headwind so strong that it took us 15 months to achieve stellar performance.  We enlisted the help of a consultant to fight the political battles while we strengthened our team.  The final result was the best revenue cycle I've ever seen:

  • 10% increase in Net Revenue collected (cash basis)
  • Days in A/R consistently < 30
  • Net Collection Ratio consistently > 98%
  • Bad Debt consistently < 2%

Lessons Learned:

  1. Performance is dependent on the People doing the work
  2. Accountability is the most powerful tool in the tool-box
  3. Learn the PM system; set it up properly; use all the modules
  4. Cooperation between the front-end (office) and back-end (CBO) is essential
  5. The physician revenue cycle is vastly different than the hospital revenue cycle

Health Information Technology

Large EMR Implementation (500+ Providers)

(Coming Soon)

Quality / Value-Based Reimbursement

Family Practice Transition to Capitation

(Coming Soon)