Revenue Cycle Management Services for the Health Provider Industry

Inadequate revenue cycle management can cost a hospital one to three percent of annual net revenues. Health systems are finding that traditional efforts to reduce expenses do not sustain financial margins, so they seek high-performance by transforming back-office activities and revenue-cycle business practices into value-added support services.

Accenture's revenue cycle management solution helps health organizations to achieve these goals, resulting not only in higher-performance in revenue management but also increased satisfaction levels that extend from the patient's room to the boardroom.

At Accenture, our experience has shown that for improved financial performance, health organizations must leverage leading practices and technologies to transform revenue-cycle processes. We also believe that an integrated solution involving both technology and process improvements at the same time will enable high performance. Our approach addresses the entire revenue cycle—from the moment a patient enters the system to final revenue collection.

We continually evolve new revenue cycle approaches to help health organizations improve their financial performance. Our clients have sustained long-term, bottom-line improvements such as reduced bad debt and denials, improved claim processing, variable cost reductions, improved efficiency and increased cash flow.

Accenture's revenue transformation methodologies are enabled by the Accenture Revenue Cycle Management Workflow Tool—an innovative and automated solution that spans the entire revenue cycle. Supporting processes through advanced technology, this tool runs directly on your in-house network and integrates all system data into a single workflow engine.

The Revenue Cycle Management Workflow Tool powers services including:

• Denial management programs: We help increase client revenue and cash flow by reducing denials and improving the timeliness and accuracy of initial claim payments. We emphasize the pre-service functions of scheduling, pre-registration, insurance eligibility and benefit verification, pre-certification, authorization, advanced beneficiary notice and medical necessity screening, financial education and financial counseling. In addition, we help to identify, classify and analyze denial root causes to explore operational alternatives.
  
  
• Cash acceleration strategies: We work with your staff to assess and identify A/R reduction opportunities to increase commitment or investment of collection resources. Although our primary objective is to help you accelerate cash flow, we also work with you to improve accounts receivables, reduce accounts receivable aging, and prioritize deployment of follow-up resources.
  
  
• Patient payment strategies: Accenture can help you establish equitable, consistent collection policies. We encourage appropriate reimbursement to reduce bad debt and improve patient relations. We help you identify and implement active point-of-service collection efforts, patient payment alternatives, accelerated patient notification and follow-up processes and alternative sourcing strategies. We help you evaluate collection and charity care policies and patient payment pricing. In addition, we work with you to address improvements to patient statements and evaluate payment satisfaction associated with the revenue cycle.
  
  
• Third-party payment compliance: We help your revenue cycle team increase collections from third-party payers. Our program includes technology-enabled tools to build front-end processes and help avoid back-end cleanup. We can also provide recommendations to simplify contract terms, which can be monitored with an automated contract management tool. Additionally, we help resolve and recover outstanding payment variances with specialized collection follow-up resources.
  
  
• Vendor contract management: We can help you reduce contracted expenses, including outsourcing vendors, billing services, and bad debt collection agencies. We conduct a broad-based evaluation of contract terms associated with third-party services and provide a business perspective to help enhance management and vendor performance. Based on our findings, we coordinate an RFP process to improve pricing and service levels.