Are You Really Managing Your Revenue Cycle — Or Just Guessing?
Introduction
Most healthcare organizations assume their revenue cycle is under control.
Claims are going out. Payments are coming in. On the surface, everything seems fine.
But when we audit these systems, we often find costly inefficiencies hiding in plain sight—missed revenue, slow follow-up, and denials that never get worked.
Common Problems in “Healthy” RCMs
Even well-staffed and fully outsourced teams can experience:
Delayed or inconsistent AR follow-up
Unaddressed denial trends
Undercoding or missed charge capture
Communication breakdowns between billing and clinical staff
These aren’t minor issues—they lead to revenue leakage, compliance risks, and lower margins.
What an RCM Audit Can Reveal
A professional audit surfaces the trends no one’s looking at:
Denials by category and payer
Aging AR by service line
Recurring documentation or coding issues
Inefficient workflows between departments
If you haven’t reviewed these in the last 6–12 months, chances are something important is slipping through.
Signs It’s Time to Reevaluate Your RCM
You may need a strategy reset if:
Your denial rate is over 5%
More than 20% of your AR is over 90 days
You can’t track real-time cash flow, denial reasons, or claim status without exporting spreadsheets
What to Do Next
Conduct a third-party RCM audit
Build a denial prevention task force with billing, coding, and clinical input
Document the full claim lifecycle and identify workflow gaps
Invest in a dashboard or reporting tool that displays key financial and operational metrics
Call to Action
Want to see what your revenue cycle is actually doing behind the scenes?
[Schedule a complimentary revenue cycle audit with our team.]