REVENUE INTERGRITY & REVENUE CYCLE MANAGEMENT (RCM)
Not getting paid what your contracts promise?
If your reimbursements aren't reflecting your contracted rates, the shortfall is larger than it appears. KHC specializes in payer and provider contract reviews, reimbursement variance analysis, and revenue cycle assessments that identify exactly where your organization is leaving money behind and why.
The Problems Revenue Integrity Solve
The healthcare industry has become increasingly complex. Complicated questions arise that require a unique blend of clinical, financial, and compliance expertise. Maintaining daily operations while ensuring revenue integrity is challenging for any organization.
Revenue Cycle Processes & Consolidation
When implemented properly, consolidating revenue cycle processes within an organization can prompt significant cost savings, improved billing and collection accuracy, and consistency across practices. KHC partners with your implementation team, providing project management support, best practices research, and ongoing feedback throughout the process.
KHC never assumes we know your business or your systems better than you do. We leverage our experience to collaborate with your team, not replace it.
Charge Description Master (CDM) Review
CDM is often overlooked in a healthcare organization. With limited internal resources for regular line-by-line reviews, inaccuracies accumulate in this critical dictionary and compound over time.
KHC works with clients to determine the right course of action, both financially and strategically. A desk audit provides a high-level review that identifies concerns across all departments. A deep dive into a specific department may be more appropriate depending on where risk is concentrated. Every KHC CDM review is tailored to your needs and budget.
We don't just consult on healthcare. We've worked inside it.
KHC provides independent, non-biased authoritative research, subject matter expertise, and complete confidentiality, so your organization gets an honest picture of where it stands and a practical path to improvement.
Our team includes:
Certified Coders • Compliance Officers • CPAs & Reimbursement Specialists • Billers • Laboratory Technicians • Nursing & Pharmacy Clinicians • Physicians
What a revenue integrity engagement covers:
REVENUE CYCLE
- Utilization review alignment to revenue cycle
- Case management assessment
- Patient access and front-end improvement
- Case mix index (CMI) improvement
- CDM review and transparency
- Coding accuracy and audits
- ICD-10 review
BILLING & COLLECTIONS
- Denial prevention and management
- Appeals processing
- Compliance monitoring
- Pre-bill review
- Key performance monitoring
- Charge capture
- Staffing and training needs assessment
Ready to find out what your organization is leaving behind?
A KHC consultant will review your situation, identify the right starting point, and outline what an engagement would look like.
