Revenue Cycle Consulting: Find The Right One

Finding A Revenue Cycle Consulting Professional For Your Practice

As a busy healthcare provider, staying on top of your practice's financial performance can take significant time and effort. If you want to keep costs low and maximize revenue opportunities, you should prioritize finding the right healthcare revenue cycle consultant for your practice. 

A professional who understands both the medical and financial aspects of the industry can provide invaluable assistance in your operations. Here are a few ways consultation can help your practice:

  • Streamlining processes
  • Improving billing integrity
  • Ensuring collections are accurate and timely
  • Advising on any potential coding errors
  • Setting critical strategies for long-term success

With our network of experienced, highly qualified healthcare consultants, you can rest assured that your practice's financial performance is in safe hands. So, what are you waiting for? Get started today!

What Is Revenue Cycle Consulting, And Why Do You Need It?

Revenue cycle consulting is an invaluable tool that helps healthcare organizations maximize efficiency and effectiveness. Industry-specialized consultants help ensure that healthcare organizations receive every last penny due to them. Even more importantly, they can optimize the flow of the revenue cycle, which helps save time, energy, and money in the long run. 

Revenue cycle consulting guarantees better performance and improved financial results, making this service a much-needed part of any successful healthcare organization's medical billing strategy.

Assessing The Qualifications Of A Revenue Cycle Consultant

When looking for a revenue cycle consultant, it is essential to assess their qualifications. They should know medical coding, billing processes, and payer requirements specific to your practice. They should also be well-versed in healthcare billing practices, relevant regulations and laws, and the complexities of today's healthcare industry. Additionally, look for a consultant who is experienced in your specialty. This will ensure you get the best advice for your industry and situation, leading to cost savings for your organization.

How To Vet Potential Revenue Cycle Consulting Professionals

The first step to improving revenue capture with the help of experienced consultants is to do an in-depth investigation. Start by asking the consultant questions about their experience and qualifications. Get references from past clients and ask questions about challenges they have faced when working with a medical practice. 

Checking Licensing And Certification Requirements 

In addition to assessing their qualifications, it is essential to check that they possess the necessary licensing and certifications. Revenue cycle consultants must be licensed by the state where they provide services to comply with local and national regulations. Different states have varying licensing requirements, so it's essential to ensure that the consultant meets all of these requirements.

Interviewing Potential Consultants 

After narrowing down the list of potential consultants, it is important to interview them. During the interview process, ask questions about their experience and the services they offer. 

Questions To Ask When Choosing A Revenue Cycle Consultant 

When interviewing potential revenue cycle consultants, ask the following questions. 

Work Experience

Some common questions related to experience with medical practices include:

  • How long have you been working with medical practices?
  • What success stories can you tell me about your work in the past?
  • What challenges have you faced when working with a practice? 


Questions about strategies for improving the revenue cycle include:

  • What strategies do you recommend for improving the revenue cycle of healthcare organizations?
  • How have you helped practices streamline their billing processes and increase revenue?
  • What methods do you use to prevent denials and rework? 


Questions about performance evaluation include:

  • Do you have any specific successes or accomplishments that we should know about? 
  • Have you ever experienced failure, and if so, how did you correct the issue? 

Tips For Working With A Revenue Cycle Consultant Effectively

Here are several tips that can help you work effectively with a revenue cycle consultant:

Communicate Regularly

It is essential to keep your revenue cycle consultant up-to-date on any changes or updates in your practice, as this can directly impact the efficacy of their work. Doing so ensures that the consultant can provide the best possible services and advice to your medical practice.

Be Open And Honest

When working with a revenue cycle consultant, it is essential to be open and honest. It is necessary to discuss any issues or challenges you are facing that could affect your practice's revenue cycle. As part of this conversation, provide the consultant with all relevant information about your practice, including its patient demographics, system capabilities, and financial goals.

Set Expectations

When working with a revenue cycle consultant, it is crucial to establish clear expectations and goals. This will ensure that the consultant can provide the right advice and revenue cycle solutions for your practice.

As part of this process, you need to clearly define the scope of work, the timeline for completion, and any milestones or targets that must be met. This will ensure that the consultant can provide the best possible services for your practice. 

Work Collaboratively

Revenue cycle consultants can help organizations identify areas of improvement in their revenue cycle, allowing for better financial and operational performance. Medical practices must collaborate with their revenue cycle consultant to meet common goals and objectives.

Benefits Of Partnering With An Experienced RCM Professional 

Partnering with an RCM consulting professional such as Enter.Health can benefit your medical practice. Here are just a few ways it can do this:

Payment Posting

Revenue cycle consultants can review an organization's payment posting process to ensure that all payments are accurately posted and reconciled. Payment posting is a critical component of the revenue cycle process, as it is the final step in ensuring that claims have been adequately processed and payments accounted for. A practical payment posting process helps organizations improve their cash flow and reduce the time spent reconciling payments.

Maximum Reimbursement

An experienced RCM professional can assist medical practices in maximizing reimbursement from insurance companies, government agencies, the health system, and other payers. Through careful analysis and execution of the revenue cycle process, these professionals can help practices identify areas for improvement and develop strategies to increase their overall reimbursement rate.

For example, our RCM professionals can help practices develop a comprehensive pricing strategy that considers the organizations' local market conditions and other factors. Through careful analysis of an organization's current policies, procedures, and payer contracts, an RCM professional can identify areas for improvement. In turn, this will enable the practice to receive optimal reimbursement.

Streamlined Operations

By partnering with an RCM professional, medical practices can streamline operations and improve operational efficiency. Our professionals have the expertise and knowledge to develop custom solutions that can help organizations reduce redundancies, eliminate unnecessary processes, and optimize their workflow.

Improved Coding Accuracy

Revenue cycle consultants can help medical practices review and optimize their coding process, ensuring they send the correct codes for reimbursement. Coding accuracy is critical to the success of any medical procedure, as incorrect codes can result in delayed payments, denials, and other issues that could affect an organization's bottom line. Enter.Health has the experience and expertise to ensure that coding is accurate and compliant with all relevant standards.

Accurate Claims

Revenue cycle consultants review an organization's claim submission process to ensure that all claims are submitted accurately and promptly. This involves a variety of tasks: 

  • Understanding the intricacies of specific payer regulations and policies
  • Monitoring timeframes for submitting claims
  • Verifying the accuracy of all information included with the claim

Reduction of denial claims is paramount to maintaining an efficient and profitable cash flow of health systems.

Insurance Follow-Up

Revenue cycle consultants review an organization's third-party follow-up process. This allows them to ensure that the practice follows up on all insurance claims in a timely manner and receives prompt payment. There are a few components involved in this process: 

  • Investigating the status of unpaid or underpaid claims
  • Understanding the intricacies of healthcare payer regulations and policies
  • Monitoring time frames for submitting claims
  • Verifying the accuracy of all information included with the claim

Get The Right Fit For Your Practice's Needs!

Regardless of a medical practice's size, partnering with an experienced RCM professional can help maximize reimbursement and streamline operations for healthcare providers. 

With Enter.Health, a leading revenue cycle management consulting service provider, you'll get the expertise and knowledge you need to run your practice as efficiently and profitably as possible. Our team of experts is trained in coding, insurance follow-up, denials management, and more. You can rest assured that your practice is receiving the best support possible when you work with us. Learn how we can help your practice at a price that works for you!

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