Services

Revenue Management

  • Annual fee schedule review.
  • Fee transparency assessment.
  • Part A/Hospital contract review and consultation, if needed.
  • Billing contract review.
  • Billing RFP/transitions.
  • Collection agency contract review and negotiations.
  • Collection agency performance review.
  • Client bill analysis.
  • Client location overview and setup analysis.
  • Implement billing of new procedures.
  • Courier services contract review and negotiation.
  • Billing process review.
  • Provide analysis of managed care contracts.
  • Analyze reimbursement by CPT in comparison to Medicare/other plans.
  • Negotiate contracts, as needed.
  • Work with billing to ensure enrollment is complete and accurate.
  • Enrollment in managed value programs and monitoring of performance, MIPS oversight.
  • Share evaluation.
  • Staffing metrics.
  • RVU correlation.
  • Banking reconciliation.

Revenue Strategy

  • Assist in billing transition to new billing service, new software and provide RCM process flow review.
  • Practice and lab strategy to increase revenue and review testing menu to maximize value.
  • Provide oversight on revenue strategy to assist the lab or practice in one-, three- and five-year revenue modeling.
  • Assist in group merger and system mergers of pathology practices.
  • Review industry trends and provide assistance with government and private payer revenue changes.
  • Salary evaluations and revenue modeling/amortizations.
  • Lab test cost and utilization services.
  • Audit current RCM process and provide a billing score sheet analysis.

Revenue Insurance

  • Audit billing performance via our 686-step revenue audit and billing scoring profile.
  • Review CPT coding and panel usage.
  • EOB auditing to ensure compliance in allowed amount payment.
  • Set, review and track billing performance indicators for charges, payments and procedures, including net collections.
  • Monitor payments by carrier. Provide quarterly assessment.
  • Review accounts receivables. Monitor aging buckets by payor and provide feedback on trends.
  • Monitor and track monthly refund activity.
  • Monitor monthly denial activity, by carrier.
  • Monitor monthly case reconciliation (accession tracking).

Who's reviewing revenue strategy with you at this time?

Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.

That’s right. For free.

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