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Home » Articles » Everything you should know about revenue cycle consulting

Everything you should know about revenue cycle consulting

Everything you should know about revenue cycle consulting

The healthcare revenue cycle should not be left behind when it comes to digital transformation in healthcare companies.[1]

Revenue cycle management heavily affects a healthcare firm’s quality of service. It ensures a continuous revenue stream and minimizes administrative work so they can care for their patients better.

However, revenue cycle management is not an easy feat. When you run private practices and small clinics, you cannot always rely simply on handling things on your own or with a small team.

Unseen challenges in revenue cycle management could greatly contribute to your revenue loss and poor patient experience. This is where revenue cycle consulting can help you improve in many ways.

This article gives an overview of revenue cycle consulting and why healthcare providers should outsource this function.

Everything you should know about revenue cycle consulting
Everything you should know about revenue cycle consulting

What is revenue cycle consulting?

Revenue cycle consulting refers to the process of analyzing a company’s entire revenue cycle, from patient registration to billing and collections. 

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It provides a bigger picture of their cycle to see points for improving their performance, especially in revenue and patient experience.

With the help of a revenue consultant, organizations can do the following:

  • Point out the root cause of their financial problem
  • Update operational strategies
  • Cut out waste and reduce costs
  • See if their management strategies work properly

How revenue cycle consulting works

In revenue cycle consulting, a medical company’s revenue cycle is reviewed and analyzed for a certain period. It usually occurs quarterly or yearly and involves a reliable consultant guiding the stakeholders along the process.

It usually starts with an overview of their healthcare revenue cycle, from the first encounter (registration) to billing.

Upon review, the revenue cycle consultant will then send recommendations on how they can improve their services. This could include strengthening employee retention, upgrading payment procedures and systems, and hiring an additional workforce.

From this, clients get an insight into optimizing their processes to enhance overall efficiency and customer experience.

What is revenue cycle consulting?

Benefits of revenue cycle consulting

Healthcare institutions lose money every period due to medical billing, claims, and other issues that could arise in charging patients. 

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Revenue cycle consulting benefits firms by providing solutions and ways to prevent these instances from happening. 

Moreso, it also provides further advantages, such as the following:

Revenue protection

According to a report by Becker’s Hospital Review, an average 250-bed hospital loses up to US$11 million in revenue due to coding and documentation errors. This shows that a simple mistype and delay in medical billing expose you to revenue loss.

Through revenue cycle consulting, you can identify any issues that cause delays in billing and claims so you can fix them. This leads to revenue protection and increased cash flow on your part.

Increased efficiency

Revenue cycle consulting can help streamline processes and identify areas of inefficiency.

For instance, consultants can suggest automating simple processes such as payment transactions and administrative support. This results in savings in healthcare spending and increased process efficiency.

Reduced waste

Around US$760 billion to US$ 935 billion in annual healthcare spending[2] is considered “waste,” according to studies. Among the main contributors to this waste is claims denial, which is mostly preventable with proper cycle management.

Revenue cycle consulting helps eliminate these wastes by analyzing the entire revenue cycle and suggesting improvements as possible.

Improved patient satisfaction

Better processing and fewer errors often translate to better patient experience and satisfaction.

Revenue cycle consulting helps medical institutions provide the best possible patient care, from initial interaction to billing and claims processing. 

At some point, this experience extends to aftercare and follow-ups.

Improved compliance

Healthcare companies are also subject to following compliances such as HIPAA, 501R compliance, and other related standards. 

Who knows, they might have inconsistent forms and documentation processes which could lead to claims denial and other billing issues.

Revenue cycle consulting can help ensure that all processes comply with applicable laws and regulations, resulting in improved compliance.

Delegating revenue cycle consulting to suitable providers

Having a clean claims rate and increased patient satisfaction can be achieved through efficient revenue cycle management and consulting.

Not all healthcare companies can manage their services in-house. They will always need another pair of eyes to see if everything works properly in their operations. Hiring in-house revenue consultants limit their ability to expand with the resources they have to provide.

A better option is to delegate revenue cycle consulting to service providers offshore. It helps medical institutions get through the complexities of revenue cycle management and manage costs at the same time.


[1] Digital transformation in healthcare companies. Hermes, S., Riasanow, T., Clemons, E.K. et al. The digital transformation of the healthcare industry: exploring the rise of emerging platform ecosystems and their influence on the role of patients. Bus Res 13, 1033–1069 (2020). https://doi.org/10.1007/s40685-020-00125-x

[2] Annual healthcare spending. Shrank, W.H., Rogstad, T.L. and Parekh, N. (2019). Waste in the US Health Care System. JAMA, [online] 322(15). doi:https://doi.org/10.1001/jama.2019.13978.

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