Healthcare Revenue Cycle Management Services

Whether you have had a change in leadership, system conversion or a slow-down in cash, Withum offers various revenue cycle and revenue recovery services including:

Denials impact the ability to realize full revenue potential. Effectively managing “true” historical denials data, identifying the root cause issues and resolving the disconnect to prevent reoccurrence in the future can be challenging for providers. Our comprehensive denials management approach assesses historical denial trends while collaborating with you to prevent future denials.

Contractual disputes, inappropriate payment and coding and billing errors all lead to opportunities to recover revenue. Our team will collaborate with payors and Medicare to recover historical revenue for up to four years.

Withum recognizes that with significant cashflow interruption, medical centers are viable candidates for our retrospective billing analysis.

Centers for Medicare and Medicaid (CMS) reimburses hospitals add-on payments over and above the Diagnosis-Related Team reimbursement for blood clotting factors and other new technologies. These payments are facilitated by coding and billing criteria but disconnects can result in lost revenue for providers. With recent increases in technology reimbursement, hospitals must ensure they are properly reimbursed. We will review Medicare claims that were incorrectly billed and recover funds to maintain positive margins for your organization.

Utilizing an interim resource allows healthcare providers an opportunity to recruit for their optimal leader. There are also opportunities to work collaboratively with an internal resource who may need short-term mentorship to step into a top leadership role. Withum’s professionals have spent their careers working collaboratively with providers in interim roles to ensure cash flow remains constant and internal goals and initiatives are achieved as planned.

Withum has extensive experience recovering additional Medicare revenue for hospitals with patients who have received inpatient care and are eligible for add-on reimbursement over and above the Diagnosis-Related Team. These include a smaller volume of patients; however, claims with the opportunity have significant revenue potential. Our highly skilled Healthcare Services Team has deep knowledge and expertise in hospital reimbursement and proven techniques integral to engagement delivery.