Specialized Revenue Opportunity

Revenue Cycle Outsourcing - Traditional vs. Specialized

When hospitals are considering revenue cycle outsourcing solutions, it's important to recognize the difference between traditional and specialized revenue. At Kemberton, we approach the hospital revenue cycle as two separate revenue systems with very different requirements for optimal performance:

Traditional

There is the traditional revenue cycle, composed of health payer claims and patient financial responsibility revenue, which constitutes the bulk of revenue and which most provider organizations have figured out how to handle at relatively high levels of reducibility and profitability without pursuing revenue cycle outsourcing.

Specialized

Then there is the specialized revenue cycle, containing dollars too costly, time-consuming and resource-intensive to efficiently pursue. Even though specialized revenue cycle typically represents close to 5% of total organizational revenue, most organizations commit few resources and little effort to maximize it, because traditional business office systems are not designed to handle the process flow efficiently and the specialized legal and third-party payer knowledge required along with the on-again off-again nature of the work makes it almost impossible to staff for internally. This is why providers often turn to revenue cycle outsourcing.

Workers’ compensation and motor vehicle are classic examples of specialized revenue, but they are just part of a broad set of third-party liability, complicated denials and other challenging payment situations that have traditionally been deemed uncollectable. 

We have developed a new kind of outsourced revenue cycle services model that combines specifically trained reimbursement and legal teams with claims workflow automation technology that gives our clients full transparency into the process, and dashboards that make tracking and predicting specialized revenue flow as easy as a few mouse-clicks.

The Results Speak For Themselves

We have already brought in hundreds of millions of dollars in lost revenue for our clients, and that is just the beginning. The results we have been able to achieve include a 3-5x improvement in total specialized revenue cycle reimbursements and A/R days, with dramatic impacts on cash-flow and bad debt performance.

From workers’ compensation to auto insurance, complex denials and the full range of specialized revenue cycle sources, Kemberton is the only one stop shop for enterprise class specialized revenue cycle outsourcing services.

The Kemberton difference

Changing the way lost revenue is found

Kemberton sat down with Healthcare Finance News and discussed how the Kemberton difference is helping hospitals collect on previously uncollectable claims through revenue cycle outsourcing, generating millions of dollars that would otherwise be lost.

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4 ways hospitals can lower claim denial rates

Kemberton’s President, Brandon Rife, discusses how hospitals can lower claim denial rates. Read these 4 tips to learn how you too can improve revenue cycle performance by lowering claim denial rates.

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A fresh approach to collecting "Uncollectible" claims

Learn how partnering with Kemberton for revenue cycle outsourcing is giving hospitals a fresh approach in retrieving uncollectible claims. Kemberton’s CEO, George Abatjoglou, explains to Hospital Access Management how getting the right people involved can secure the payment.  Most hospitals do have the right resources, but different departments are not acting in unison. A single, unified team acting under the same set of goals makes the difference, increasing the chance of a successful appeal.

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