The Power of the Unknown: Leveraging AI to Aid Your Revenue Cycle Practice
Let me start by saying that while AI (Artificial Intelligence) has been hailed as a game-changer, I approach it with a fair degree of skepticism. It is easy to be swept away by the hype, but AI is a tool [...]
Joey Parker Joins the Pinnacle Healthcare Advisors Team
We are delighted to announce Joey Parker is joining the Pinnacle Healthcare Advisors team! With 13 years of impressive experience implementing, optimizing, and automating Epic’s Hospital Billing application, Joey brings a wealth of knowledge and expertise to our team. [...]
Tally Holland Joins the Pinnacle Healthcare Advisors Team
It is with great pleasure that we welcome Tally Holland to the Pinnacle Healthcare Advisors team! With over 20 years of comprehensive experience in healthcare revenue cycle management and operational leadership, Tally has a proven track record of optimizing financial [...]
Emerging Payment Models: Value-Based Care and its Impact on Revenue Cycle
OverviewOver the past several years, hospitals and health systems have continued to face significant challenges such as rising inflation and staff shortages. These issues have strained many providers' missions to deliver high-quality health care. Emerging payment models, particularly Value-Based Care [...]
Jenna Brew Joins the Pinnacle Healthcare Advisors Team
We are thrilled to welcome Jenna Brew to the Pinnacle Healthcare Advisors team. With a decade of experience in healthcare, Jenna has honed her expertise in leading patient access teams and spearheading performance improvement initiatives. Her background includes significant roles [...]
Paige Popp Joins the Pinnacle Healthcare Advisors Team
We are delighted to welcome Paige Popp to the Pinnacle Healthcare Advisors team. Paige has over 30 years’ experience leading and developing Patient Access teams focusing on process efficiency, Patient Experience, technology integration, financial clearance, and regulatory compliance. Paige has [...]
Designing and Calculating Your System’s Denial Rate
As electronic health records systems and vendor tools have become more and more sophisticated, a myriad of metrics and KPIs are readily available to health systems with the click of a button. Some executive scorecards can have upwards of 20-30 [...]
Bringing Transparency to Epic Hospital Billing
All too often, when ramping up at a new Epic client, PinnacleHCA consultants find ourselves sifting through Excel-based dashboards to validate data, trends, or issues. Additionally, it is not uncommon for a CFO, Director of Revenue Cycle, or functional Team [...]
Key Considerations for Legacy AR Rundown Strategy
OverviewSystem conversions necessitate extensive planning, design, resource commitment, and resource alignment. One of the key components of a successful conversion that sometimes gets underestimated or overlooked is the strategy for the legacy system accounts receivable (AR). One of the first decisions [...]
Patient Access: Opening the Front Door to the Revenue Cycle
After 20 years working in all facets of the revenue cycle, I still believe that providing additional support and pay parity to Patient Access is where we need to focus more of our time, energy, and resources. Patient Access is [...]
Laszlo Tarjan Joins the Pinnacle Healthcare Advisors Team
We are pleased to welcome Laszlo Tarjan to the Pinnacle Healthcare Advisors team. Laszlo has over 10 years of consulting experience helping providers optimize front- and back-end revenue cycle processes, streamlining operations through automation, and delivering sustainable EHR solutions. In [...]
Epic PB: Understanding and Improving Your Pre-AR (and the “Pre” Pre-AR You May Not Even Know About)
Epic Pre-AR equates to unposted charges that are held in Charge Review work queues (WQs). Fluctuations in Pre-AR are common yet can have a significant impact on your actual AR days, gross revenue, cash flow, visit statistics, provider productivity/compensation, and even [...]
An Integrated Approach to a Case Management Denial Prevention Program
Case Management (CM) plays a pivotal role in ensuring the Revenue Cycle (RC) operates efficiently and effectively by improving patient care and patient relationships, reducing denials, and enhancing the organization’s overall financial performance. Within the denial reduction scope, an effective [...]
Navigating Net Revenue and Revenue Cycle Performance: Strategies for Alignment
In the intricate dance of healthcare financial management, the connection between Net Revenue and Revenue Cycle performance is often overlooked or misunderstood. Finance teams may wield their analytical magic at month-end, declaring success or failure against budgets, while the Revenue [...]
Helping Patients Navigate the Shifting Landscape of Healthcare Costs
As the cost of healthcare increasingly shifts to patients, revenue cycle leaders and staff in healthcare organizations need to be ready to handle the challenges and responsibilities of this new reality in healthcare.
Successfully Managing Your Remote Revenue Cycle Team
The field of revenue cycle management in healthcare has been rapidly changing over the years leading to an increasing number of revenue cycle teams adopting alternative work arrangements. This trend was accelerated by the pandemic, which forced revenue cycle staff [...]
Preparing for a Seamless EMR Transition: Essential Steps for Revenue Cycle Success
Are you considering replacing your EMR system? Before diving into a new installation for your Revenue Cycle, it's crucial to explore several key prerequisites. While these topics often arise during the implementation process, addressing them beforehand can significantly streamline your [...]
Implementing Epic Revenue Guardian
Revenue Guardian is a module within Epic which identifies areas of opportunity to increase charging efficiency and more importantly, catch accounts with missing charges. If your healthcare organization is using Epic’s Resolute Hospital Billing application and you do not have [...]
Managing Your Outsourced Revenue Cycle
When healthcare organizations outsource their Revenue Cycle Management (RCM), they can “potentially” experience noteworthy cost savings and improved efficiency. Nonetheless, managing an outsourcing partner and achieving desired outcomes comes with its own set of challenges and oftentimes significant setbacks in [...]
Andrew Tyus Joins the Team
We are delighted to welcome Andrew Tyus to the Pinnacle Healthcare Advisors team. Andrew has over 10 years of progressive revenue cycle consulting experience. In addition to his strong foundation in patient access and business office process improvement, Andrew has [...]
Jim Martin Joins the Leadership Team
It is with great pleasure that we welcome Jim Martin to the Pinnacle Healthcare Advisors leadership team. Jim is a consulting leader who works closely with his clients to understand, diagnose, and treat their complex revenue cycle challenges. He has [...]
Ehson Afshar Joins the Pinnacle Healthcare Team
We are delighted to welcome Ehson Afshar to the Pinnacle Healthcare Advisors team. Ehson has experience supporting all aspects of the revenue cycle, with a strong specialization in denials prevention and management. He utilizes his expertise in these areas to [...]
Marci Mollman Joins the Pinnacle Healthcare Team
We are delighted to welcome Marci Mollman to the Pinnacle Healthcare Advisors team. Marci has experience in all facets of revenue cycle and is most passionate about the patient access realm. She leverages her technical and operational expertise in this [...]
Ryan Hutten Joins the Pinnacle Healthcare Team
It is with great pleasure that we welcome Ryan Hutten to the Pinnacle Healthcare Advisors team. Ryan has a unique blend of clinical, revenue cycle operations and Epic applications experience and utilizes his expertise to provide holistic solutions to his [...]
Yuri Karev Joins the Pinnacle Healthcare Team
We are pleased to welcome Yuri Karev to the Pinnacle Healthcare Advisors team. Yuri helps hospitals and health systems improve their approach to revenue cycle, both through technological optimizations and targeted coaching. Yuri has worked across all areas of the [...]
Veronica Molares Joins the Pinnacle Healthcare Team
We are excited to welcome Veronica Molares to the growing Pinnacle Healthcare Advisors consulting team. Veronica has over 15 years of experience working with healthcare organizations to develop strategic solutions to improve overall revenue cycle performance. She has managed multiple [...]
Leon Chang Joins the Pinnacle Healthcare Team
It is with great pleasure that we share Leon Chang has joined the Pinnacle Healthcare Advisors team. Leon has approximately 16 years of experience in healthcare consulting and management with an emphasis on margin improvement. Leon is an expert in [...]
Coding Backlogs – What is Your Root Cause?
Blog Article By Vickie Bridge and Cheryl Nicholson Coding backlogs can create havoc on accounts receivables (A/R). Just as patient visit volumes fluctuate so do the number of patient accounts that need coded. Reduce coding backlogs with a consistent, proactive [...]
Medicare Annual Wellness Visits: Driving the Patient’s Personalized Prevention Plan
Many providers think administering Medicare Annual Wellness Visits (AWV) is simple and easy. In reality, numerous providers continue to struggle and face challenges with developing the patient’s five-to-ten-year personalized prevention plan as required by Medicare. Medicare requires the personalized plan [...]
Rebuilding Your Medicare Annual Wellness Visit Program in the Age of COVID
Provider volumes for medically necessary and preventive care visits dropped dramatically at the start of the COVID-19 pandemic. Volumes for medically necessary visits have largely rebounded because of the relaxed telehealth and in-person visit guidelines, and providers have an opportunity [...]
Pinnacle Welcomes Vickie Bridge to the Team
We are happy to announce Vickie Bridge, MBA, RHIA, CPHQ, has joined the Pinnacle Healthcare Advisors consulting team. Vickie comes to us with over 20 years of experience working for and consulting with hospitals and physician practices to drive sustained improvements in net revenue [...]
Case Study – Christus St. Vincent
The Challenge-CSV completed an Epic EMR conversion thirteen months prior to the Pinnacle engagement where they modeled the design after a separate, larger hospital, within the healthcare system. As opposed to the 2-year design and 3-6-month stabilization that typically accompanies [...]
Client Testimonial – Christus Health
Client Testimonial – Christus Health "I initially engaged with Pinnacle for an interim leader for our CHRISTUS® Trinity Mother Frances Ministry, an integrated health system in Northeast Texas that is responsible for over $1 billion of annual cash collections. They [...]
Getting More Out of Your Epic Activity Codes
Productivity. The mere mention of the word elicits a variety of reactions throughout a business office. How we measure and drive productivity can have a significant impact on metric performance, as well as team morale. Topics such as how to measure [...]
Revenue Cycle Reporting – Refocusing on Quality Over Quantity
Do you feel like you have too many reports? Do you feel like your teams measure the same things in different ways? Revenue Cycle reporting and analytic solutions can take many shapes and sizes in today’s healthcare industry. Some organizations [...]
Kicking the Tires on Vendor Management: The Basic Questions to Ask
Vendors are an integral part of every revenue cycle solution. From software/technology to outsourcing/AR management – and everything in between. In an ideal world – vendors would run autonomously and produce expected results without management or oversight. Unfortunately, this is [...]
Black Holes the Watchlist Doesn’t Even Know About
What’s more dangerous than a black hole of accounts not assigned for anyone to work? A population of accounts that appear as if they are assigned, but are not being managed at all. This is what we call an “invisible [...]
Getting the Most from Your Interim Revenue Cycle Leader
Some people view an interim leader as a stop gap between an outgoing revenue cycle leader and the next leader to fill the permanent role; someone to manage the day-to-day and maintain performance. We would contend that, in the Revenue Cycle space, [...]
Keeping an Eye on the Watch List – Epic Tips & Tricks
Customization in Epic is a blessing and a curse. If you can get it right, it can drive reporting and workflows that far exceed functionality of other EMR platforms. When it goes wrong, it can result in information overload and [...]
3 Factors that Reduce the Accuracy of Your Hospital’s Cost Estimation
Price transparency has become a major topic of discussion within healthcare. To offer greater transparency, healthcare providers can use products to automatically estimate a patient’s liability prior to service. However, the accuracy of the estimate is what truly provides transparency and allows patients to make informed decisions.
Do You Really Know Your AR?
Cliff Notes Much of what we consider our accounts receivable will never be collected Inaccurate variance logic will continually over/under represent AR Hospitals need to evaluate the likelihood of a positive outcome and ensure staff work corresponding populations Vendors should [...]
Addressing the Hidden Issues of Automated Cash Posting
15-20 years ago, the cash posting unit of a hospital was one of the larger units within the business office. Lots of man hours were needed each day to organize and manually post paper checks/remits from the wide variety of [...]
Top 5 Missed Epic Revenue Cycle Optimization Opportunities
Epic is a platform within the healthcare industry which generates a strong love/hate relationship. On one hand, it centralizes information and opens communication across the provider spectrum. On the other hand, many supposed efficiency gains are bogged down in tedious [...]
Are Your Epic HB Workqueues Broken? Here’s How to Fix Them
Workqueues (WQs), worklists, spreadsheets, reports. They are all trying to help us answer the same question. What accounts should we work and in what priority? How frequently is your PFS management team asking staff to re-sort their workqueues, work off spreadsheets for special projects, or work through a stack of paper denials? Workqueue build in Epic is one of the most critical pieces of your install and ongoing maintenance. After all, these are the primary workdrivers for your exception-based workflows. But are you really working the exceptions? Are your workqueues setup as effectively as you’ve been led to believe?
Pinnacle Welcomes Kevin Blanchard to the Team
We are pleased to announce Kevin Blanchard has joined the Pinnacle Healthcare Advisors team. Kevin has extensive experience leading revenue cycle transformation engagements with large multi-system hospitals, pediatric hospitals and single-facility hospitals. Kevin’s areas of expertise include Epic Resolute Hospital [...]
Accounts Receivable Outsourcing – 3 Keys to Making a Decision
Three Keys to Outsourcing Success In our last newsletter, we introduced the blog series: Why AR Outsourcing Fails and How to Avoid Common Pitfalls. We introduced two primary dangers with outsourcing arrangements: Hospitals that outsource frequently relinquish full control to [...]
Why Accounts Receivable Outsourcing Fails & How to Avoid Common Pitfalls
Your internal self-pay team can’t handle the increasing volume of calls. You’re aged insurance accounts receivable (AR) continues to increase. Or maybe your internal resources just don’t have the necessary expertise (or time) to work a specialty population like out-of-state [...]
Getting in Front of the Self-Pay Trend in 2018
There’s no denying that self-pay (SP) is on the rise. It’s a clearly established trend. If you are looking to improve your facility’s financial performance, then the SP category must be a significant part of your revenue cycle focus. Here [...]
Managing the Shift from Traditional Medicare to Managed Medicare Plans – Here’s How to Get It Right
As the mix within Medicare continues to shift from traditional to managed plans, hospitals that don’t take steps to address the differences in administrative expectations and claims processing between plan types run the risk of increased denials and mounting accounts [...]
The Anatomy of a Revenue Cycle Scorecard
Using metrics to drive actions that improve financial results Managing your revenue cycle in a world of shifting populations, increasing patient financial responsibility, and competitive pressure on volumes can be challenging, to say the least! There are so many variables [...]
How to Determine if Your Current EHR Platform Can Solve Your Revenue Cycle Challenges
Don’t Buy More Software! - Four questions to help determine if your current EHR platform can solve your revenue cycle challenges When hospitals determine that they have a challenge to be solved within their revenue cycle, it is extremely common [...]
Case Study – Randolph Health
Building a Best Practice Hospital Revenue Cycle The Challenge The unemployment and poverty rates in Randolph County, North Carolina, exceed both state and national levels, contributing to an unusually large number of uninsured patients in Randolph Hospital’s service area. [...]