Hospital Revenue Management

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Experts in Health Plan Coverage and Hospital/Physician Operations.

  • Complex and Outsourced Financial Clearance
  • Healthcare Consulting & Process Improvement
  • Denial Trending, Recovery and Prevention
  • Payor Audit Defense
  • Utilization Review & Management
  • Interim Management
  • Zero Balance Account Review
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Key Service Lines

We are focused on revenue cycle excellence. Our services lines focus on
ensuring you’re paid timely and accurately by all third party payors.

Financial Clearance

Healthcare Consulting
& Process Improvement

Utilization Review
& Management

Audit and Recovery

Denials Management

Why Choose Us?

We are a small, boutique firm having both the bandwidth to give you the attention you deserve and the passion to provide only the highest level of customer service and outcomes.
Our audit and recovery software is unlike any other software available today; coupled with our physician revenue cycle expertise, our solution is unsurpassed in the industry.
We have unique expertise in both physician and hospital revenue cycles, with experience in registration, coding, billing, auditing, payer claims processing, managed care contracting, utilization management, revenue integrity, denials, payment posting, and follow-up.
Finally, our professionals have served in leadership roles at various healthcare systems and have an in-depth understanding that comes from being on the “front lines,” where you are now.
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Financial Clearance

We work with payors to ensure that entire plan of care is authorized and confirmed as a covered benefit. Our proven innovative approach:

  • Increases overall reimbursement
  • Improves patient satisfaction
  • Boosts patient volumes
  • Reduces operational disruptions
  • Eliminates administrative burden
  • Provides clarity for patients and families
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Healthcare Consulting & Process Improvement

Our seasoned professionals and highly skilled associates work collaboratively with your teams to design and implement the right solutions for your unique challenges and needs. We utilize our Lean Six Sigma certifications and experience to ensure we find and remediate the root cause of the problem.

  • Revenue cycle assessments to identify inefficiencies, gaps, and risks
  • Policies, procedures and process flow diagrams
  • Updated workflows for new regulations or compliance
  • IT implementation support and project management
  • Staffing analysis and organizational realignment
  • Quality assurance reporting and training development
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Utilization Review & Management

Our seasoned professionals work collaboratively with your teams to design and implement the right solutions for your unique challenges and needs.

Staff Augmentation – Our experienced nurses provide initial and concurrent reviews in all care settings. They are proficient in evidence-based criteria platforms and up-to-date on the latest Medicare and Medicaid regulations.

Outsourced Concurrent Reviews – Our teams can fully manage your utilization review department to ensure optimal staffing ratios, operational policies, timely appeals, and regulatory compliance.

Specific Populations – Given responsibility for a specified population, our teams will conduct initial and concurrent reviews, appeal denials, and maintain regulatory compliance.

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Audit & Recovery

Our technology-first approach identifies underpayments in zero-balance account populations that other solutions miss:

  • Increased Recoveries
  • Reduced Cost to Collect
  • Timely Resolution
  • Flexible Deployment
Key Differentiators are:

  • Next-Generation Technology
  • Proprietary Billing & Coding Audits
  • Automated Approach
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Denials Management

Maximize recoveries and minimize revenue loss.

  • Customized solution to enhance your denials program
  • Comprehensive denial trending to discover prevention strategies
  • Flexible offerings implemented alone or in combination
  • Lightweight implementation can deliver recoveries in less than 30 days
  • Virtual extension of your business office
  • Seamless integration with existing processes
  • End-to-end services with underpayments managed through to recovery
  • Contingency-based fee structures present no risk to you
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