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REVENUE CYCLE MANAGEMENT

Revenue Cycle Optimization Services That Plug Revenue Leaks

Revenue cycle optimization services find where your practice loses money between the patient visit and the final payment, then fix those leaks one by one. ZanexMed audits your claims, denials, A/R and payer contracts and builds a clear plan to raise collections.
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  • Full audit of claims, denials and A/R
  • Leaks ranked by dollar value
  • Fixes tracked in monthly reports
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    RCM in medical billing

    What Are Revenue Cycle Optimization Services?

    Revenue cycle optimization services review every stage of the billing process, from scheduling and eligibility to coding, claims, payments and collections, and fix the steps that lose money. The goal is more revenue from the same patient volume.

    Revenue leaks are usually small and spread out. A missed charge here, an unappealed denial there and a payer underpayment that nobody checks. Together they can take a large share of collections.

    An optimization review finds the biggest leaks first, so effort goes where the money is.

    Where Revenue Leaks

    These are the places we look first in every audit.
    • Eligibility errors that cause front end denials
    • Missed charges and incomplete charge capture
    • Coding errors that under bill services
    • Claims sent late or rejected and never fixed
    • Denials written off without an appeal
    • Payer underpayments below contract rates
    • Patient balances that are never collected
    • Out of network claims that could go to negotiation or IDR

    How Our Revenue Cycle Optimization Services Work

    Our revenue cycle optimization services follow six steps from audit to monitoring.

    1. Free revenue audit

    We review a sample of claims, denials and A/R to see where money is lost.

    2. Data analysis

    We study payer performance, denial reasons and payment patterns.

    3. Rank the leaks

    Every leak is ranked by dollar value and how easy it is to fix.

    4. Fix plan

    We agree on a plan with owners, dates and expected results.

    5. Implementation

    We fix workflows, scrubbing rules, coding and follow up processes.

    6. Monitor results

    Monthly reports show whether each fix is working.

    Revenue cycle optimization services workflow from audit to measured results

    Optimization Areas and Typical Fixes

    Each area has its own common leak and its own fix.
    AreaCommon leakTypical fix
    Front endEligibility and authorization errorsVerify before the visit and track authorizations
    Coding and chargesMissed charges and undercodingCoding audits and charge capture review
    ClaimsLate or rejected claimsFast submission and payer specific scrubbing
    DenialsWritten off without appealRoot cause analysis and appeals
    PaymentsUnderpayments never noticedCompare payments with contract rates
    PatientsBalances that are never billedClear statements and payment plans

    Start With Our Free Tools

    You can get a first look before you talk to anyone. Our Revenue Leakage Estimator shows how much revenue a practice may lose each year, and the IDR Claim Checker tests whether an underpaid out of network claim may qualify for dispute resolution.

    For industry guidance on revenue cycle performance, see the Healthcare Financial Management Association. When you are ready for a full review, our team will run the audit with you and share results through monthly reports.

    GOT QUESTIONS?

    Revenue Cycle Optimization Services FAQs

    Revenue cycle optimization services review each step of the billing process, find where revenue is lost and fix those steps so the practice collects more of what it earns.
    Common signs are rising denials, growing A/R over 90 days, payments below contract rates and claims that are never appealed. A free audit measures the leakage in dollars.
    A first audit can be done in a few weeks once we have access to your billing data. Fixes then roll out in stages, starting with the biggest leaks.
    Recent claims and denial reports, A/R aging, payer contracts if available and access to your billing system or EHR.
    Yes. We review out of network underpayments and send eligible claims to negotiation or IDR. See our out of network claim negotiation service.
    Pricing depends on scope. Many practices start with a free audit and move to a percentage of collections plan, typically 3% to 8%. See our pricing page.

    RELATED SERVICES

    Explore More ZanexMed Billing Services

    Billing Reports

    Clear dashboards for claims, A/R and denials.

    Denial Management

    Find the root cause of denials and appeal with proof.

    Medical AR Management

    Follow up on aging claims until they are paid.

    Out of Network Negotiation

    Recover more on underpaid out of network claims.

    Ready to Find Your Revenue Leaks?

    Talk to ZanexMed about revenue cycle optimization services and get a free revenue audit.
    Get a Free Revenue Audit