Specialized Revenue Opportunity
Specialized Revenue Cycle
We look at the hospital revenue cycle as really two separate revenue systems with very different requirements for optimal performance:
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.
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 management outsourcing services.