Objective:

Optimize quality standards, proficiency and returns in the RCM process.

Specific Consulting Services through GULFHRA

 

 

a) Change Management:

Change management is the discipline that guides how we prepare, equip and support individuals to successfully adapt change in order to drive organizational success and outcomes.

Communicating Change in the Revenue Cycle

   Analysis:
         Audits, interviews, process control, outcome, return on investment, project viability.
  Reporting and Strategy:
         Focused on key decision makers – key operational representatives and important decisions.
  Process Optimization:
         Revenue cycle enhancement.
  Communication:
         RCM–ergonomics, flow, objectives vs tasks and responsibilities.
  Clinical Optimization:
  • Improved workflows.
  • Improved
  • Human Resource pool.
  • Maximize usage of features of EHR/EMR system.
  • Optimize and standardize documented processes.
  • Align EHR/EMR with strategic goals.
  • Optimal collaboration between clinicians and HIM.
  • Coordinate information flow between departments.
  • Benchmark within new healthcare environment.
  • Financial outcomes (gap analysis, resource optimization, margins).

b) Business and Financial Competency Growth:

In business, growth is not an option, it is imperative. We help you focus on this from the business perspective.
  • Expand market relevance (Expand business models and know the impact of RCM on the forecasted growth).
  • Margins (Managing Margins create a safe environment for staff and decision makers).
  • Payment Integrity
  • Price Transparency
  • Business Office Suite
  • Patient Access
  • Revenue Optimization

c) Risk Management:

Forecasting and evaluation of financial risks with identification of procedures to avoid or minimize their impact on business objectives.
  • Segregated versus Integrated functions.
  • Leak Management
  • Financial implications
  • Standards
  • Certifications

d) End-Process Analysis and Support:

  • Auditing – Establish gaps – (front end facilitation to back end functions).
  • DRG/E&M accuracy reports (Up-coding and Down-coding).
  • Identify Problem accounts to decrease A/R Days and Lower Credit balances.
  • Denial Management
  • Payer contract negotiations.
top