Services

Revenue Cycle Management

In a healthcare industry where margins are razor thin, DIVURGENT Revenue Cycle services allow organizations to address financial performance weaknesses and identify areas of improvement. Our consultant engagements may be short-term assessments or longer-term engagements that redesign the organization's revenue cycle processes, policies and practices. We ensure revenue cycle success by focusing on processes and technology to improve cash flow, produce fewer claim denials, reduce payment delays and increase collections.

Improving your bottom line is our goal, so our revenue cycle experts partner with your organization to determine potential areas for improvement and the combination of services necessary to address them, and provide a plan to achieve those objectives. The outcomes of our engagements include system optimization, operational efficiency, reduction in A/R days and increases to cash flow.

Our Revenue Cycle Consulting optimization services include:

	CDM Reviews
	Conduct organization wide CDM analysis developing: centralized/de-centralized strategies   Cleanup requirements   In-house versus out-source options   Conduct facility level comprehensive APC/CDM/Charge Capture Reviews   Conduct focused departmental reviews for high impact areas as needed   Conduct clinical system(s) to CDM reviews   Provide Managed Care contract reviews   Implement review recommendations
	CDM Maintenance - Outsourcing & Support
	Support for CDM system adds, changes, deletions   Support for developing workflow capabilities for CDM processing (Sarbanes-Oxley Compliance)   Support and maintenance for Quarterly/Annual HCPCs, CPT, and UB revenue codes   Develop strategy for charge utilization monitoring
	Table Maintenance Review
	Review and analyze Auto charge table(s)   Review and analyze charge warning and edit mechanism(s)   Review and provide recommendations for enhanced Revenue/Payor specific charge maintenance   Review of and support for Revenue Code(s) maintenance   Review of and support for Patient Accounting/General Ledger tables
	Facility Support & Education
	Support daily interaction with hospitals for charging problem resolutions, assistance in billing regulations and charging practices   Review and develop CDM policies, charge protocols & implementation approaches   Development & maintenance of education courses and material   Develop & conduct organization and facility specific training
	Medical Billing Audit (Chart Audit)
	Develop Monthly Chart Audit Reporting strategy and process   Develop and conduct Chart Audit Training   Recommend and develop Chart Audit Policies & Procedures o Develop and deploy workflow into Chart Audit processes   Provide Routine support for facility and organization wide audit functions   Development of robust reporting/trending tools   Development and implementation of Industry and organization specific best practices   Develop online calendar/scheduling and documentation abilities
	Litigation Expertise and Consulting

Clients that utilize DIVURGENT Revenue Cycle Consulting benefit from:

	Industry best practices
	Enhanced financial performance
	Increasing profitability
	Unmatched experience in Revenue Cycle financial and operational areas
	Improved regulatory compliance performance

DIVURGENT provides revenue cycle consultants with an optimum mix of clinical and billing/coding experience as well as the appropriate software to ensure successful RCM engagements.