Maximize Revenue Cycle Performance
Strategic RCM consulting and medical coding services that improve billing accuracy by 25-40% while reducing denials and accelerating cash flow through AI-powered optimization
The RCM Challenge
Healthcare organizations face mounting pressure from declining reimbursement rates, regulatory complexity, and operational inefficiencies
High Denial Rates
Average industry denial rates of 9-12% result in millions in lost revenue annually
Extended Collection Cycles
Days in A/R averaging 50+ days create significant cash flow constraints
Billing Inaccuracies
Manual processes and coding errors lead to claim rejections and rework
Compliance Violations
Complex regulatory requirements create audit risk and penalties
Our RCM Approach
McKinsey-inspired methodology combining strategic assessment, solution design, and continuous optimization for sustainable RCM excellence
Comprehensive RCM Assessment
24-month claims data analysis using AI-powered tools to identify denial patterns and root causes
Key Deliverables:
- Current state analysis with benchmarking
- Denial pattern identification
- Revenue leakage quantification
- Process gap analysis
Gap Analysis & Benchmarking
Industry benchmarking and performance gap identification across all RCM functions
Key Deliverables:
- Industry benchmark comparison
- Performance gap identification
- Priority opportunity ranking
- ROI potential assessment
Solution Design & Roadmap
Custom transformation strategy with technology integration and process optimization
Key Deliverables:
- Target state architecture
- Implementation roadmap
- Technology requirements
- Change management plan
Implementation & Change Management
Expert-led deployment with continuous monitoring and staff training programs
Key Deliverables:
- Technology deployment
- Process implementation
- Staff training programs
- Performance monitoring setup
Optimization & Continuous Improvement
Ongoing optimization with performance tracking and proactive denial prevention
Key Deliverables:
- Performance optimization
- Continuous monitoring
- Quarterly business reviews
- Improvement recommendations
Service Offerings
Comprehensive RCM services with AI-powered automation and proven results
Medical Coding & Billing
Expert medical coding with ICD-10, CPT, and HCPCS compliance ensuring maximum accuracy
- Certified coding specialists
- Quality assurance programs
- Staff training & certification
- Audit support & documentation
Claims Management
End-to-end claims processing optimization with automated workflows and exception handling
- Automated claim scrubbing
- Real-time eligibility verification
- Exception handling workflows
- Performance analytics
Denial Management
Systematic denial reduction through root cause analysis and prevention strategies
- Denial pattern analysis
- Automated appeals processing
- Prevention strategies
- Recovery optimization
AI-Powered Solutions
Advanced AI and automation tools for predictive analytics and workflow optimization
- Predictive denial analytics
- Automated coding assistance
- Real-time dashboard monitoring
- Integration with existing systems
Expertise & Credentials
Industry-leading expertise with proven credentials and technology partnerships
RCM Consulting Team
Combined 200+ years of RCM experience across hospital systems and healthcare networks
Technology Partnerships
Strategic partnerships with leading healthcare technology providers for seamless integration
Compliance Certifications
Full regulatory compliance across all healthcare standards and requirements
Engagement Models
Flexible engagement options tailored to your specific needs and transformation goals
Project-Based Consulting
Deliverables:
Comprehensive analysis with actionable recommendations
Managed Services
Deliverables:
End-to-end RCM management with performance guarantees
Hybrid Model
Deliverables:
Strategic consulting plus managed implementation
Implementation Timeline
Clear milestones and expected outcomes for your RCM transformation journey
Assessment
Current state analysis, data gathering, stakeholder interviews
Design
Solution architecture, technology selection, roadmap development
Execution
Implementation, training, process optimization, go-live support
Optimization
Performance monitoring, continuous improvement, quarterly reviews
Common Questions
Answers to frequently asked questions about our RCM consulting services
How long until we see measurable results?
Clients typically see initial improvements within 30-45 days, with full transformation results realized within 3-6 months of implementation.
What's included in a typical RCM engagement?
Comprehensive assessment, solution design, technology implementation, staff training, change management, and ongoing optimization support.
How does pricing work for RCM consulting?
We offer flexible engagement models including fixed-fee projects, performance-based contracts, and hybrid arrangements tailored to your specific needs and goals.
Can you integrate with our existing systems?
Yes, we have extensive experience integrating with major EMR/EHR systems including Epic, Cerner, Athenahealth, and NextGen Healthcare platforms.
What about ongoing support after implementation?
We provide comprehensive post-implementation support including performance monitoring, optimization recommendations, and managed services options.
Ready to Transform Your Revenue Cycle?
Schedule a consultation to discuss how our RCM expertise can optimize your billing accuracy, reduce denials, and accelerate cash flow