Revenue Cycle Analysis

EASTERN REGION:

An academic medical center with a comprehensive cancer center, retained ECG to address billing, coding, documentation and revenue cycle issues.  The frontend and backend revenue cycle review included ambulatory chemotherapy and infusion area, and the associated oncology pharmacy.  Charge masters for all services were reviewed.

ECG consulting services included:

• Assessment of processes from time of patient registration, prior authorization and pre certification, check-in, diagnosis coding, charge capture pre- and post-interface to finance and collections were assessed.

• Onsite audit correlating nursing documentation with encounter documentation, physician orders, and time based billing for services provided.

• ECG developed detailed recommendations and findings for all areas assessed.

Outcome:

Compliance, cancer center and finance staff developed new processes based on ECG findings and recommendations.