Revenue Cycle+ Services

We design and implement – in collaboration with our clients- patient-centered solutions for sustained improvements in revenue cycle performance. Our comprehensive revenue cycle management services address key revenue cycle processes, with emphasis on:

End-to-End Workflow Optimization:

• Analytics Driven Revenue Cycle Workflow Optimization

Front Cycle:

• Eligibility and Benefits Verification
• Referral, Authorization and Pre-Certification
• Financial Clearance
• Provider Enrollment & Credentialing

Mid Cycle:

• Coding & Coding Audit for all venues of care
• HCC Coding
• Coding Edits and DNFB Optimization
• Denial Coding
• Remote CDI
• DRG Validation
• Clinical Validation
• Data Quality Services
• Transcription
• Medical Record Excerpts & Indexing

Back Cycle:

• Claim & Remit Advice Processing
• Insurance and Self-Pay AR Follow Up
• Denial Management

Cerner Millennium & Soarian Financials and Clinicals Analytic Services

Custom Reports:

• Create custom reports combining any related Soarian as well as interfaced Millennium and/or third party data sources.
• Create custom data marts and universes to enable client-defined reporting in new subject areas.
• Improve performance of existing custom report procedures, or create more efficient tailored versions of Soarian model reports to meet specific use cases.
• Improve throughput in Reporting Day End to drive earlier report availability.
• Enhance responsiveness of on-demand reports.
• Add performance logging to any new or existing custom report queries to pinpoint any current or future performance problems.
• Support partially automated regression testing for any new or existing custom report procedures and provide guidance on the use of related tools and techniques currently included in the Millennium/Soarian model report procedures.

Custom Data Marts & Cubes:

• Customize existing cubes, and if needed, their data sources to meet requirement gaps in Soarian model cubes.
• Create new OLAP cubes and data sources not currently supported in model.
• Recreate custom cubes after an upgrade event.

Custom KPIs and Executive Metrics:

• Create new KPI’s within the Healthcare Intelligence KPI tool spanning revenue cycle and clinical metrics.
• Create new Millennium/Soarian Executive Metrics.

SAP BusinessObjects Universes & Web Intelligence (Webi) Reporting:

• Create specialized universes in various subject areas to meet requirement gaps and/or to provide improved performance.
• Create user-defined Web Intelligence (Webi) reports from the universes to meet client specific needs. Soarian data, captured metrics and imported 3rd party data are accessible through universes.

Inbound and Outbound Extracts Support:

• Provide inbound and outbound extracts to support other enterprise objectives including inputs to:
  • ERP Systems
  • Financial Clearance Systems
  • Price Estimation Systems
  • Cost Management Systems
  • Analytics/ Decision Support Systems
• Meet automation requirements when using tools such as Cerner Healthcare Extensibility Platform (HEP) or DataBound emue.

Import Data from 3rd Party Systems:

• Create efficient import procedures
• Design data structures to store the imported data
• Reconcile imported data with sending system
• Utilize imported data in Custom Reports, Cubes, KPIs, Executive Metrics, Universes, Webi reports

Export Data to 3rd Party Systems:

• Create efficient export procedures
• Reconcile exported data with receiving system if technically feasible
• Create data sources for automation tools such as HEP and DataBound

Ongoing Monitoring and Upgrade Support, for any of the above:

• Analyze impact of upgrade, including database changes and SQL Server version, on reports data marts and cubes to support upgrade planning.
• Mitigate Soarian or Healthcare Intelligence upgrade impacts by modifying reports, data marts and cubes, as required, for Soarian upgrade events.
• Provide appropriate ongoing monitoring.

Support for Price Transparency Rules Compliance & Online Price Estimation Tools

Our team members have been working with Cerner clinical and financial data for the past 20 years. It gives us the unique ability to effectively identify the data element required to support your Price Transparency related business objectives. We can provide inbound and outbound extracts to support enterprise Price Transparency Rules Compliance objectives.

Extract current chargemaster, revenue and usage information from Soarian & surround solutions to support:

• Assessment of the accuracy, completeness and currency of chargemaster data.
• Competitive intelligence.
• Strategic pricing program for optimal recalibration of price by service.
• Rational pricing model assembled around cost, reimbursement, and peer pricing data.
• CMS requirements:
  • Machine Readable file
  • Consumer Friendly file
• Data inputs for the Patient Estimation tools.

Upgrade Support:

• Analysis of upgrade impact, including database changes and SQL Server version, on reports data marts and cubes to support upgrade planning.
• Mitigation of Soarian or Healthcare Intelligence upgrade impacts by modifying reports, data marts and cubes, as required, for Soarian upgrade events.

Ongoing Monitoring & Support Option & Deliverables:

• Price transparency regulatory support maintenance program including monthly/ quarterly/ annual updates to the JSON/ CSV/ XML machine-readable file.
• Updates to the high-low posting requirements throughout the course of the year due to payer negotiations and resulting rate changes with health systems.
• Annual posting refresh requirement pursuant to the Rule.

Advisory Services

We orchestrate the pairing of healthcare industry SMEs with leading-edge practices and processes.

• Revenue Cycle Process Transformation
• Revenue Cycle Systems Program Management
• Clinical Informatics
• Payor-Provider Collaboration
• M&A Due Diligence & Valuation
• Cross-Border Transactions (US-India, US-Philippines)
• Go-To-Market Strategy Development