Maximize Healthcare Outcomes with Revenue Cycle Optimization

The revenue cycle encompasses a series of critical functions that are essential for the financial success and sustainability of many different healthcare organizations. Without an optimized Revenue Cycle, your organization faces risk of occurring higher administrative costs and burdens as well as a decrease in overall revenue. Our team at Signature Performance is fully equipped to tackle any revenue cycle challenges you may have with over 21 years of healthcare experience in both the federal and commercial sectors. By partnering with an expert like Signature Performance, you can more efficiently manage your organization's needs, improve your financial performance and can allocate your time and resources to what is most important to your organizational goals. 

Four Revenue Cycle Functions to Master

Patient Access & Insurance Eligibility/Discovery

The revenue cycle begins with Patient Access or registration and scheduling. Accurate capture of patient demographic and insurance information is crucial for successful billing and reimbursement practices later on in the revenue cycle. Did you know that nearly 50% of Patient Access information is captured incorrectly? By ensuring that patients provide correct and complete information, they can also better understand their up-front financial responsibilities and can help reduce future billing and collections errors. A lack of consistency in the discovery process can lead to long-term issues down the road that could cause financial setbacks for the patient and your organization.

Medical Coding and Auditing

Medical coding involves translating diagnoses, procedures, and services into universally adopted codes to ensure proper billing and reimbursement. Accurate coding is essential as it directly impacts the amount insurers will pay for the services your organization administered. For example, if a provider codes the patient encounter as a one-time visit when in reality it was a second or third visit, you could run the risk of undercharging for the services rendered. Proper documentation and adherence to coding guidelines is crucial to avoiding claim denials and compliance issues for the healthcare organization. By enlisting highly-specialized coding experts, like Signature Performance, you can trust your coding will be completed correctly, the first time, to improve the likelihood of maximum payment and reimbursement.

Claim Submission, Management and Follow-up

Managing the status of claims throughout the reimbursement process is essential to ensure they are paid efficiently and accurately. The submission process involves compiling all necessary documentation including patient information, insurance details, and coding documentation, to create a final claim. This includes tracking the status of submitted claims, identifying and resolving claim errors or denials, and following up with payers to expedite payment should there be delays.  Our Signature team of Claims experts stays up-to-date on the latest coding and billing changes, payer requirements, and industry trends to help you maximize the success of your claim submissions.

Denial Management, Appeals, and Patient Billing/Collections

Denials occur when insurance payers refuse to reimburse healthcare organizations for services provided during patient encounters. Effective denial management involves identifying the root causes of denials, appealing denied claims when appropriate, and implementing strategies to prevent future denials. It is essential to the health of your organization that payments are collected in a timely manner to ensure revenue generation and improve cash flow. With Signature's team of Revenue Cycle experts, you can reduce delays in revenue collections and can identify trends and reasons for routine denials.

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Each step of the Revenue Cycle plays a crucial role in ensuring the financial viability and success of your organization. By effectively managing these functions, you can optimize revenue capture, improve cash flow, and enhance your ability to deliver high-quality patient care. By partnering with Signature Performance, you can focus your time and resources on what is most important to your organization and can rest easy knowing our people, processes, and technology solutions can maximize your Revenue Cycle.

Learn more about Signature's Comprehensive Revenue Cycle Solutions.