Freed Associates

Revenue Maximization

The revenue cycle is a critical component in improving cash flow, reducing costs, and providing good customer service in the health care industry. Whether you are a medical center, foundation, IPA, or payer, you must address numerous handoffs and communications, exchanges of data, accuracy challenges, and regulatory requirements.

Freed Associates helps clients streamline the flow of revenue through their organizations.  Freed consultants identify current and potential impediments in the revenue stream and customize solutions to remove those barriers.  Our clients utilize our expertise to accelerate cash, improve charge capture and billing accuracy, reduce denials, and establish transparency and accountability across all aspects of the revenue cycle.

Revenue Cycle Assessment and Optimization

The revenue cycle is constantly changing, influenced by regulatory requirements, the need to provide and exchange clear information with providers, patients, review, and billing entities. Freed works with clients to improve cash flow and customer service.

  • Assessment of the entire revenue cycle from scheduling to collection, including account and RA sampling, workflows, and data analysis and integration
  • Evaluation and recommendations to improve data captured by registration, insurance verification, and financial counseling
  • Development of key performance indicator reporting and accountability for all areas involved in the revenue cycle
  • Evaluation of departmental charging processes to reduce lost charges and improve reimbursement
  • Implementation of charge capture, cost and pricing including Charge Description Master (CDM) for appropriate coding, matching entry and loss, recommendation on CDM pricing, and calculation of revenue neutrality for new charging methodologies
  • Evaluation of claims operational structure including best practices on claims productivity, organizational structure, and claims representative accountability

Contract Compliance

Healthcare organizations devote significant resources to contract negotiation, hoping to secure fair and equitable rates for patient care. Freed Associates helps safeguard accurate claims processing and ensure that all parties meet their contractual obligations. Freed’s Contract Compliance services include:

  • Assessment of claims processing accuracy, including reporting on payment variances
  • Assessment of claims processing timeliness, including timely billing and payment
  • Evaluation of variance identification, appeal, and dispute resolution processes
  • Evaluation of compliance with other contract terms, including audit terms, supplemental information requests, fee accelerators, etc.
  • Development of tools and processes to monitor and enforce continued compliance

Denial Management

Denials have become an insidious problem in healthcare – a study by the California Nurses Association found that the state’s largest insurers rejected 22% of medical claims submitted by providers between 2002 and 2009. Freed Associates helps its clients minimize denials and improve quick, accurate claims payment through the following services:

  • Sampling of processed claims to evaluate denial frequency, documentation, and primary issues
  • Assessment of denial data captured through both electronic and hard copy correspondence
  • Development of customized tools to categorize denial causes and quantify net revenue risk
  • Department-level consulting to implement sustainable solutions and ensure ongoing accountability

ICD-10 Planning, Assessment, and Implementation

The entire healthcare industry will be impacted by the transition to ICD-10, currently proposed to occur on October 1, 2014. Freed Associates understands that each healthcare entity is impacted differently, but each will need to assess, plan, design, build, test, and deploy solutions for areas such as: information technology system remediation strategy and testing, people readiness, reporting/analytical issues, crosswalk challenges, trading partner readiness, and risk management solutions. Freed helps its clients with ICD-10 readiness through the following services:

  • PMOs and portfolio/program/project management
  • Strategic planning and alignment and implementation team design
  • Technical implementation strategies
  • Organizational readiness, communication, and training (especially for physician and coder adoption)
  • Impact assessments,and workflow and productivity analysis
  • ICD-9/ICD-10 crosswalk strategies, including vendor selection and solution implementation
  • External trading partner readiness, testing, and certification
  • ICD-9/ICD-10 reporting and analytics strategies
  • Financial forecasting and guidance for minimizing negative impacts to A/R (provider) or A/P (payer)

To learn more about our Revenue Maximization service line, please contact us.