Revenue Cycle Management Performance Consultant Services

Consultant to provide comprehensive assessments of DCT operations to optimize the revenue cycle and standardize practices.
- The Consultant will evaluate processes and technology workflows to identify gaps and opportunities to improve revenue capture, improve cash flow, reduce claim denials, and minimize operational and compliance risks.
- Registration, Patient Access and Admissions.
1. Assess DCT’s patient access processes and evaluate the impact on revenue capture and claim reimbursement.
2. Identify operational gaps associated with inaccurate or incomplete patient demographic information, insurance data, and eligibility verification.
3. Provide recommendations to improve copays and deductibles collection and reduce claim reimbursement denials and delays.
4. Areas to review include but are not limited to the following:
a. All admission and registration processes
b. Minnesota State Operated Community Services (MSOCS) Group Homes and Vocational Services
c. Minnesota Sex Offender Program
d. Minnesota Forensic Mental Health Program
e. Inpatient Psychiatric Hospitals for adults and children/adolescents
f. Intensive Residential Treatment Services (IRTS)
g. Substance Use Disorder programs
h. Dental
i. Outpatient Services
j. Central Pre-Admission wait list
k. Standardization of registration, insurance verification, and financial collection practices
l. Identification of process gaps that may contribute to lost revenue
- Clinical & Medical Records/Coding Validation.
1. Assess documentation, coding, and charge-capture processes to identify opportunities to improve documentation timeliness, completeness, and coding accuracy.
- 2. Review process gaps that contribute to delayed billing, compliance risks, loss of revenue, and incomplete or unsupported claims for preventable denials.
3. Areas to review include but are not limited to the following:
a. Medical coding processes across all service line types
b. Clinical documentation across allservice types
c. Chart completion requirements and compliance
d. Development of a unified chart-completion policy across DCT
e. Alignment of clinical documentation, coding, charge capture, and billing requirements
f. Identification of opportunities to improve documentation quality and revenue capture
- Information Technology (IT) & Health Informatics.
1. Assess technology systems configuration, interfaces and workflows that support DCT’s revenue cycle operations.
2. Identify opportunities to improve financial performance, data processing and billing accuracy for timely reimbursement to reduce revenue loss and manual processing.
3. Areas to review include but are not limited to the following:
a. Informatics policies and procedures that affect Revenue Cycle and Finance
b. Electronic Health Record (EHR) configuration supporting charge capture and billing
c. Interfaces between clinical, financial, and billing systems
d. Data transmission and reconciliation processes
e. System-related causes of missing charges, billing delays, and claim denials
f. Opportunitiesto improve automation, data integrity, and financial reporting