Revenue Cycle Management

Optimize Hospital Revenue with Clinical Intelligence

At Brundage Group, our philosophy is centered around merging knowledge with acumen to optimize hospital earnings. We recognize the importance of hospitals being profitable while prioritizing providing quality care to patients. That’s why our strategy revolves around harmonizing these two aspects. Allow us to guide your hospital toward a future where financial health and outstanding patient care seamlessly coexist.

Achieve Financial Stability with Ease

Empower your hospital’s financial health with Brundage Group: Integrate clinical insights to compliantly capture earned revenue.

Achieve Financial Stability with Ease

Empower your hospital’s financial health with Brundage Group: Integrate clinical insights to compliantly capture earned revenue.

How We Can Help

Our unique strategy uses innovative revenue cycle solutions to provide end-to-end support for the clinical revenue cycle, from patient status verifications to denial support.

In-depth Workflow Insights

  • Comprehensive analysis with actionable recommendations individualized to your organization.
  • Thorough evaluation of current processes highlighting efficiencies, gaps, and potential pitfalls.

Benchmarked Value Assessment

  • Strategic comparisons against industry standards and competitors.
  • Customized opportunity identification aligned with your specific value objectives.
  • Customized Implementation Strategy

    • Merge future-focused operational model planning with detailed project timelines and initiative planning for cohesive and efficient execution.
    • Combine strategic resource allocation with a meticulously crafted schedule focused on the effective realization of projected benefits that promote sustainability.

    Key Components of Hospital Clinical Revenue Cycle Management

    Grasping clinical revenue cycle management (CRCM) paves the way for improved profitability while also enhancing patient satisfaction. CRCM focuses on understanding key components such as utilization review, provider clinical documentation, accurate inpatient coding, and denials management that profoundly shape hospital finances.

    • Utilization Management: Patient insurance verification, obtaining preauthorization, and validation of admission orders are key components in hospital revenue cycle management. These initial steps ensure accurate patient financial records that enhance administrative efficiency while minimizing financial risks.
      • Claim Submission & Processing: Claim submission and processing is crucial. Understanding and mitigating inefficient clinical revenue processes that slow the billing process and contribute to revenue leakage.
        • Denial Management: Denial management plays a crucial role in hospital revenue cycle management. This strategy involves analyzing denied claims, rectifying inaccuracies promptly, resubmitting to ensure efficient revenue recoupment and implementing processes to reduce future denials. Mastery of supporting medical necessity and claim coding language is paramount for your billing team’s successful liaison with insurance providers.
          • Clinical Revenue Cycle Reporting: CRCM reporting involves tracking of key indicators such as the inpatient ratio and denial rates. This allows hospitals to evaluate their financial health accurately.
          • Customized Revenue Cycle Management for Hospitals

            At Brundage Group, we understand the distinct challenges that confront healthcare organizations. Our suite of clinical revenue cycle management services and training is meticulously tailored to cater to your organizational requirements. In collaboration with our experienced physician advisors and subject matter experts, we seamlessly incorporate our platform into your existing workflows, thereby facilitating an optimized approach to clinical revenue cycle management. Trust us to provide personalized and effective solutions tailored specifically for your hospital.

            Optimize Revenue Performance with Brundage Group

            Advanced Analytics and Data-Driven Insights

            At Brundage Group, as your trusted healthcare advisor, we offer excellent and insightful assistance in optimizing your clinical revenue cycle. We work with healthcare systems of various sizes across the country, providing physician advisory and subject matter expert services. Our analytics platform identifies actionable opportunities for improvement within the clinical revenue cycle through thoughtfully organized dashboards and reporting. Identifying areas of opportunity allows Brundage Group to accurately identify claims that may need additional clinical review to prevent revenue leakage. Brundage Group can automate case submission to create an efficient process that reduces turnaround time.

            Seamless System Integration and Support

            Brundage Group acknowledges the importance of achieving smooth system integration to enhance a healthcare system’s clinical revenue cycle. Our partnership with Redox, a platform designed to facilitate rapid and secure healthcare data transmission, along with our experience with a variety of Electronic Medical Records (EMR), enables quick onboarding. This vital capability streamlines the onboarding procedure for hospital systems and guarantees prompt clinical revenue cycle support. At Brundage Group, our goal is to efficiently optimize clinical hospital revenue cycles while maintaining the highest standards of data security.

            What’s Included in Clinical Revenue Management Services

            Brundage Group’s Clinical Revenue Management Services encompass a comprehensive suite of offerings designed to optimize financial performance in healthcare. These services include:

            Patient Status

            Providing guidance on the most clinically appropriate patient status and monitoring of observation cases for upgrade opportunities.


            Coding and Documentation

            Ensuring accurate clinical documentation and coding for appropriate billing and compliance.

            Compliance and Audit Support

            Providing expertise in regulatory compliance and audit readiness.

            Denials Management

            Analyzing and addressing denials to improve revenue recovery.

            Performance Analytics

            Utilizing data analytics for informed decision-making and performance improvement.

            Revenue Cycle Training and Education

            Offering specialized training and education programs for healthcare professionals to enhance their revenue cycle management skills and knowledge.

            Brundage Group’s Strategic Clinical Revenue Optimization

            Brundage Group ensures your hospital stays financially healthy. We focus on capturing revenue smartly, compliantly, and sustainably without forgetting the big picture.

            The Goals of Clinical Revenue Cycle Management

            The ultimate goal of Revenue Cycle Management is to streamline administrative processes, maintain financial stability within the hospital setting, and promote prompt payment for services rendered. With efficiency at the core of managing clinical revenue cycles, it also serves as a crucial platform for bolstering patient satisfaction rates by reducing confusion or unforeseen costs.

            Improving Financial Performance

            At Brundage Group, we utilize strategic methods to improve cost management, revenue streams and operational workflows for hospitals. We prioritize minimizing claim denials and increase payment speed while maximizing reimbursement opportunities from insurance providers.

            Enhancing Billing Quality

            We advocate hospitals streamline their medical coding and billing processes efficiently and compliantly. We leverage technologies such as artificial intelligence (AI) to identify claims prone to error, automate case submission processes, and provide educational feedback with every review to help reduce future errors and speed up claims processing.

            Utilizing Technology Solutions

            We utilize advanced platforms to streamline processes while reducing costs. With AI and Robotic Process Automation (RPA) at the helm, repetitive tasks are minimized so your team can concentrate more on strategic roles.

            Achieving Regulatory Compliance

            We strive for precision in clinical documentation and medical coding to achieve regulatory compliance. Our experienced CRCM experts emphasize the importance of conducting regular audits of clinical revenue cycle departments to validate compliance with applicable Medicare and professional guidance. Brundage Group also offers staff and provider training based on regulatory guidance and industry standards that are crucial for maintaining clinical revenue cycle integrity.

            Why is Clinical Revenue Cycle Management Important?

            Clinical Revenue Cycle Management (CRCM) is highly valuable in hospitals. This process ensures efficient financial operations, enabling medical centers to focus on serving their communities and patients.

            Improve Efficiency and Accuracy

            Streamlined operations through clinical revenue cycle management greatly decrease revenue leakage. An efficient CRCM allows for the elimination of obstacles that lead to payment delays, speeds up workflow, and improves accuracy. This ultimately improves the overall productivity and the financial stability of the healthcare system.

            Ensure Timely Reimbursements

            Clinical Revenue Cycle Management (CRCM) speeds up the process of receiving payments for services. With a well-structured CRCM system, hospitals can eliminate delays in collecting revenue. It ensures prompt billing and consistent receivables to promote financial stability for health systems.

            Reduces Billing Errors and Claim Denials

            Clinical Revenue Cycle Management identifies potential billing errors by verifying patient status and medical coding claims data. Early detection of potential problematic claims reduces the administrative burden associated with appeals by reducing the likelihood of claim rejections.

            Facilitate Compliance with Regulations

            Compliance with regulations is essential for successful Clinical Revenue Cycle Management (CRCM). By adhering to Medicare regulations and industry standards, clinical revenue cycle departments maintain ethical practices.

            Benefits of Clinical Revenue Cycle Management

            When you optimize your clinical revenue cycle with Brundage Group, expect a positive ripple effect. This strategy can enhance cash flow by reducing billing errors and lead to increased staff satisfaction.

            Lower Costs and Errors

            Reducing errors in coding and billing can save your healthcare system money. A streamlined clinical revenue cycle management (CRCM) process lowers operating costs by reducing the chance of incorrect or denied claims. Furthermore, an efficient workflow ensures quicker reimbursements to keep hospital finances healthy.

            Streamlined Billing Processes

            Streamlining billing processes adds significant value. Swift reimbursements occur when the accuracy of patient status, coding, and claims submission is improved. This efficiency propels financial health by reducing claim rejections and ensuring a consistent revenue flow.

            Data-Driven Decision Making

            The use of data-driven analytics is a fundamental part of Clinical Revenue Cycle Management (CRCM). By analyzing key financial indicators, healthcare organizational leadership can identify patterns and trends that inform organizational strategies. This approach helps make calculated changes to boost effectiveness, reduce errors in billing processes and optimize revenue flow.

            Enhanced Compliance Requirements

            Enhanced compliance requirements bring rigor to healthcare services. Accurate patient status assignment and medical coding helps mitigate risks of payor denials, support audits and provides legal adherence while upholding patient care integrity and protecting the institution’s reputation.

            Frequently Asked Questions

            What is Brundage Group's approach to patient status verification?

            At Brundage Group, our expert physician advisors understand the documentation needed to support an ordered level of care across all payors. We have a variety of tools that allow us to create efficient case review processes that minimize the use of organizational staff, allowing them to focus on other duties. Our professional physician advisors have experience working with a variety of payors to overturn medical necessity denials through peer-to-peer discussions. Levering Brundage Group for patient status support allows treating providers to remain at the bedside, providing patient care. It also creates a level playing field when discussing cases with the payor’s medical director, who only performs administrative functions.

            How does Brundage Group ensure coding accuracy?

            Our team at Brundage Group is dedicated to providing accurate and compliant medical coding services. We stay up to date on the latest coding standards through continuous staff education to ensure that our clients receive top-notch accuracy and adherence to current regulations.

            What strategies does Brundage Group use for effective claim submissions and denials management?

            Our team at Brundage Group is committed to providing thorough and efficient claim submission services. Through strict checks and balances, we ensure that all submissions are properly managed for optimal revenue flow. With our team of denials experts, denials are promptly addressed and resolved to streamline the process for you.

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