RCM Lessons Learned from Mimi Howie

  How is the RoundTable approach to RCM different than its competitors? Leveraging our depth of RCM and IT experience, RTSS customizes solutions based on our client’s needs. This includes people, process, and technology. We tailor these three integrated approaches to drive sustainable improvements in any area of your Revenue Cycle. With over 25 years of Revenue Cycle experience, our consultants have worked in prestigious & financially successful medical systems affording us the opportunity to learn from the best and pay it forward. Over the years we have learned what works and what doesn’t, thus creating our own catalog of Best Practices. As an RCM partner, we share these Best Practice solutions with our clients and offer elbow to elbow support to drive change and deliver exceptional results.  What have been some of the challenges to implementing a robust RCM operation in health systems and hospitals today? While there are many challenges to share, a long-standing obstacle [...]

2020-03-06T14:53:54-05:00March 6th, 2020|Healthcare IT, Revenue Cycle|
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Lessons Learned: Diagnostic Laboratory

RoundTable’s team of experienced and talented consultants are our frontline ambassadors sharing their expertise with our clients, and in turn, offering the best lessons learned from each unique partnership project.  In the series, Lessons Learned, we will dive deep into the reflections of the experiences of some of our recent ventures.  We will provide our thoughts on processes, communications, challenges, impacts and recommendations in order to give our audiences more industry insights - with the goal of achieving future healthcare successes. In this first issue, we review several lessons learned on how laboratories must capture all available revenue and at a lower cost, even with continued reimbursement compression, due to PAMA (Protecting Access to Medicare Act) and payor contractual reductions. Top Five Diagnostic Laboratory Lessons Learned on How to Accomplish This Include: 1. Automation is key to obtain accurate and timely information to create, transmit and receive payment for clean claims and reduce costs. 2. Alerts and [...]

2020-10-25T20:39:59-04:00December 9th, 2019|Access, Revenue Cycle|
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What is Revenue Integrity Anyway?

What is Revenue Integrity? According to the National Association of Healthcare Revenue Integrity, “the basis of revenue integrity is to prevent the recurrence of issues that can cause revenue leakage and/or compliance risks through effective, efficient, replicable processes and internal controls across the continuum of patient care, supported by the appropriate documentation and the application of sound financial practices that are able to withstand audits at any point in time.” But people often think about Revenue Integrity quite differently from this “cut-and-dried” definition. In fact, it’s become something of a hot topic. Some people think it’s simply a department that maintains the Chargemaster. Others view it as a more robust cross-functional team with insight and knowledge of the entire revenue cycle. As subject matter experts, they can identify and resolve gaps that cause revenue leakage. Here, at RoundTable Strategic Solutions, we view Revenue Integrity as a program, strategy and department focused on eliminating revenue leakage and maximizing [...]

2019-11-14T15:54:43-05:00November 14th, 2019|Revenue Cycle, Revenue Integrity|
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Revenue Cycle: Addressing the Talent Gap While Improving Performance

Over the last three years, healthcare systems (hospitals + medical groups), specifically within the Revenue Cycle function, have seen a dramatic shift in the standard for Talent and Performance.  Reimbursement changes, consumer demands / expectations, the breakdown of silos and the centralization of key functions has demanded more sophisticated and higher quality talent who can deliver top notch results – financial, operational and cultural performance.  Many health systems throughout the country, and more specifically in smaller but competitive markets, have struggled to fill key Revenue Cycle leadership roles with the right level of talent. TALENT. RoundTable’s interim leaders (industry top talent) have lived inside the four walls of a healthcare system for the majority of their careers, leading successful and high performing teams and functions (both Hospital & Ambulatory), and now leverage their strong background and experience to assist organizations in filling Interim Revenue Cycle Leadership roles while also improving performance, centralizing / standardizing key functions, developing [...]

2018-10-26T09:36:36-04:00October 26th, 2018|Interim Healthcare Executives, Revenue Cycle|
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Coders: A Major Puzzle Piece in The Revenue Cycle

Finding all the pieces of a puzzle is sometimes difficult.  One thing in healthcare that is clear-- coders are a big part of the Revenue Cycle puzzle.  After attending the AAPC HealthCon 2018, two concepts are extremely evident: 1. Coders own a critical piece of the revenue cycle puzzle. 2. Coders need to expand their knowledge of revenue cycle operations by engaging in cross departmental discussions that have typically taken place in silos and should be viewed as a strategic resource to help SOLVE the puzzle! The What:  What do they need to know?  Coders’ expanded knowledge is now required to fully understand their role within the revenue cycle.  Their job can no longer be that of just silent coding for hours, day in and day out. Rather, there needs to be an educational component of how they fit into the revenue cycle and how their role, which is sometimes overlooked, is an integral part of optimizing [...]

2018-06-06T14:41:29-04:00June 6th, 2018|Revenue Cycle, Uncategorized|
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Building Blocks to a Successful Revenue Integrity Program

According to industry experts and research, 68%* of organizations that implemented a new revenue integrity department increased net collections and gross revenue capture. Alignment between health system CFOs, Revenue Cycle, Physician, Compliance and Operational leadership is critical to successfully launch or enhance a Revenue Integrity strategy and program.  Leveraging outside experts who have designed, implemented and built Revenue Integrity programs inside complex delivery systems can balance the organizational drive to increase revenue with the imperative to comply with legal and contractual rules. Partnerships with health system leadership can assist in creating a strategy, defining an achievable plan to optimize your existing Revenue Integrity program or implement a program that mitigates risk to revenue - ensuring compliance, leveraging existing coding/charge capture tools and technology, and creating a sustainable model to embrace both fee for service and value-based care reimbursement models. Below are 7 Key Steps to Consider When Building Your Revenue Integrity Program Obtain buy-in with Executive Leadership, [...]

2018-05-03T11:10:39-04:00April 12th, 2018|Revenue Cycle|
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Never Stop Learning and Leading – HIMSS18 Takeaways

Each year, the RoundTable team book their flights for the annual HIMSS conference, and 2018 was not any different.  We were eager to get to the conference to meet new industry leaders and hear more about one of the conference’s main themes centered around the patient experience, which aligns perfectly with our Management Consulting service lines – Healthcare Customer Experience & Relationship Management (HCxRM) and Revenue Cycle Growth & Integrity. As we attended multiple sessions and walked the show floor, we saw several trends and had six major takeaways: 1- Interoperability The industry is experiencing interoperability issues which have spawned a whole host of middleware and interoperability vendors and consultants. The true solution relies upon creating and enforcing healthcare standards within the software frameworks themselves instead of allowing health records companies to continue to develop proprietary software. 2- Technology, Data and Analytics...and what to do with it? In the early days of the internet, websites had the [...]

2018-03-15T17:58:13-04:00March 15th, 2018|Conferences, HCxRM, Management Consulting, Revenue Cycle|
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Growth & Operational Re-Design: Building a Sustainable Model

Over the last seven years, many healthcare systems (hospitals and physician groups) across the country have seen significant growth through acquisition. Gaining market share through acquisition provides an immediate competitive advantage, however, this type of inorganic growth impacts revenue cycle, financial performance and the overall consumer experience. In recent months, CFOs, Vice Presidents of Revenue Cycle, and Executive Directors have engaged RoundTable Strategic Solutions to develop a go-forward strategy to improve the financial viability and stability of their organization while identifying opportunities to enhance/optimize patient access and the overall consumer experience. Our proven approach provides clients with solutions that leverage operational re-design, reduce manual processes using information technology and create a sustainable model for growth within today’s healthcare delivery and rapidly changing reimbursement model. RoundTable’s Management and Revenue Cycle Consulting teams are guiding many large and complex healthcare delivery systems in the following areas: • DRIVING A NEW CULTURE OF PERFORMANCE & GROWTH: Providing Interim Revenue Cycle [...]

2017-12-20T21:29:00-05:00November 8th, 2017|Management Consulting, Revenue Cycle|
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