Challenge
As a result of a financial audit, our client, a premier physician-led medical group, recorded a material write-down of net revenue and accounts receivable due to impaired collectability from inadequate and sub-scale Revenue Cycle Management (RCM) processes.
The Synergetics team conducted an in-depth business analysis of RCM operations focusing on the following areas:
- Revenue Leakage, i.e., net revenue to cash realization
- Cost-to-Collect Analysis, i.e., RCM labor and non-labor spend
- Effective use of RCM tools and technology
- RCM organization, i.e., spans of control, on-shore vs. off-shore resource deployment and scaling for growth
Solution
At the conclusion of the business analysis, Synergetics was engaged to implement the business analysis recommendations to improve overall RCM performance. Unknown at the time, this was just before a very substantial (>35%) increase in claim volume due to Covid-19, primarily in the urgent care business segment.
Working closely with leadership and staff – both in RCM and operations – the Synergetics team re-tooled RCM functions from account creation through final account resolution.
Primary focus areas included:
- Optimized labor from implementing a blended-shore model
- Enhanced vendor management
- Increased automation
- Improved utilization of RCM tools
