In today’s environment of healthcare reform and reimbursement model changes, healthcare organizations need a strategic vision for their revenue cycle built on collaboration and designed to accelerate cash flow, increase net revenue and reduce expenses. FTI Consulting has a proven track record in revenue cycle optimization and performance improvement. Leveraging our team’s extensive revenue cycle experience, we work collaboratively with our clients to develop customized solutions driven by leading practice tools, strategies, and initiatives. We recognize that each healthcare provider’s revenue cycle is unique and has its own set of challenges. To that end, FTI Consulting offers a wide spectrum of services ranging from focused, individual initiative solutions (e.g., denials prevention) to end‐toend revenue cycle transformation solutions to address the specific needs of each organization. FTI Consulting’s process and technology optimization strategies consistently produce significant cash acceleration and recurring financial benefits ranging from 3% to 6% of net income improvement, generally within 12 to 18 months.
- Access Management
- Revenue Integrity
- Case Management, Clinical Resource Management and Patient Throughput
- Clinical Documentation and Coding Integrity
- Denial Prevention
- Patient Financial Services
- Managed Care Contracting
- Strategic Revenue Cycle Planning
- Customized Implementation for Shared Services
- Revenue Recognition
- Accounts Receivable Valuation
- Financial and Operational Results and Outcomes
Our fully integrated, patient‐centric approach to Patient Access enhances access to care, data collection, and provider reimbursement by holistically evaluating and optimizing the people, processes, and technologies that drive access to care within an organization.
We leverage deep expertise within CDM maintenance, department charge capture, and ambulatory coding and charge auditing processes to develop seamless workflows and processes that yield sustainable results.
Case Management, Clinical Resource Management and Patient Throughput
FTI Consulting’s methods enhance patient outcomes, reduce length of stay, maximize authorized inpatient days, and reduce level‐of‐care denials.
Clinical Documentation and Coding Integrity
We help our clients implement multidisciplinary programs that improve the completeness and specificity of clinical documentation and coding. We leverage data analytics, benchmarking, chart reviews, and query audits while simultaneously educating clinical documentation specialists, providers and coders. We implement leading practice CDI, coding, and HIM process enhancements to help our clients achieve compliant results.
FTI Consulting helps our clients reduce denials by implementing a sustainable denials governance structure, prioritizing root cause analysis, enhancing EHR/RCM functionality, and improving multidisciplinary communication between key stakeholders.
Patient Financial Services
Our collaborative efforts with client partners focus on developing optimal accounts receivable (A/R) management strategies that lead to increased quality and productivity from staff, efficient workflows and processes, and optimized technological tools that resolve A/R in a timely and effective manner.
Managed Care Contracting
We assist our clients in adapting to and optimizing changes in healthcare reimbursement and value‐based payments through a range of services that include contract review and benchmarking, negotiation strategies and support, operation reviews and analysis, and value‐based care readiness and contracting options.
Strategic Revenue Cycle Planning
Our experts develop customized roadmaps for the implementation of a scalable and sustainable operating model and revenue cycle management structure.
Customized Implementation for Shared Services
FTI Consulting methodologies and tools can be applied to a discrete revenue cycle function, such as scheduling, or to the entire revenue cycle. This comprehensive approach to revenue cycle management keeps FTI Consulting clients ahead of the constantly evolving needs of the industry with the latest solutions for business integration. Our solutions promote accountability, standardization, economies of scale, and an enhanced patient experience.
Without regard to a provider classification (for‐profit, not‐forprofit, or governmental) of a hospital unit, medical group or other providers the primary revenue source is patient revenue. One of the largest challenges in healthcare is to determine "net" patient revenue. The adjustment of “gross charges to expected net realizable revenue” can be fraught with risk and inaccuracy. Having a solid revenue recognition policy and methodology is paramount to mitigate this risk.
We assist our clients in assessing existing policies, designing and implementing a standardized revenue recognition policy or acting as a trusted advisor when estimates prove elusive and stay ahead of the changing accounting rules.
Accounts Receivable Valuation
One of the largest assets for any healthcare provider is its accounts receivable (A/R). Generally, the A/R valuation considers the age and activity of the underlying accounts. There are various formulas that can be applied which will give a reasonable estimate, however, a specific review and solid valuation methodology that periodically reviews and confirms this estimate is essential.
FTI Consulting assists our clients in by designing and implementing a standardized accounts receivable valuation policy. In tandem with the revenue recognition, an appropriate accounts receivable valuation methodology performed monthly and reviewed periodically mitigates potential risks or can serve as an early warning indicator for possible overstated revenues.
Financial and Operational Results and Outcomes
- Expanded access to care
- Reduced registration errors
- Increased staff efficiency
- Increased revenue capture
- Compliant billing programs
- Decreased claim edits and denials
- Decreased bad debt
- Increased net revenue realization
- Accelerated cash collections
- Enhanced use of technology
- Enhanced patient, staff, and physician satisfaction