The current environment for healthcare delivery involves significant challenges such as intense competition, heightened expense management, and evolving technological advancements. Given the complexities of the industry, many healthcare organizations realize improvements by focusing on basic business practices such as consistent revenue, reduced costs, personnel efficiencies, and compliance. These goals – amongst others – are often achieved through specialized revenue cycle management (RCM). Pinnacle has worked with clients for over 25 years providing professional fee RCM, with results including improved processes, lower costs, and increased profitability. As a proven RCM provider, Pinnacle regularly works with medical practices to effectively restructure revenue cycle activities to optimize operations and boost financial results. We also support our hospital clients by providing expert RCM and advisory services associated with professional fee billing for their physician and provider services. Thus, as a complement to denial management and EMR-focused revenue cycle services to include audit, chart review, and education offered by our Coding & Compliance team, Pinnacle’s outsourced RCM services offer a solution to clients who wish to capitalize on our expertise, ensure predictable cash flow performance, and maintain their focus on patient care.
Healthcare organizations must contend with numerous complex issues ranging from providing quality care to navigating changes in regulatory and payor requirements. As such, many medical practices and hospitals benefit from outsourced RCM to optimize operations and improve revenue. Pinnacle’s RCM team regularly supports clients in this area by managing professional fee provider services. As part of these services, we work toward improving insurance contracts, conduct regular client meetings to optimize medical billing procedures, and provide advisory services on an as-needed basis. We pride ourselves in our level of quality customer service and aim for clients to regard our team as a trusted partner who can identify trends and complete analysis to reduce accounts receivable and improve collections. In fact, one key element setting Pinnacle apart from other outsourced RCM organizations is that we do not solely rely on robotic algorithms for submitting claims. Instead, our team of experienced professionals assess claims to ensure they are payable. By taking this approach, we help clients streamline their efforts with the goal of delivering positive results in a short time. We also work to build specialty-focused revenue cycle teams to appropriately resource the front end of the RCM process such that our clients save the time and resources otherwise needed to pursue collections on the back end. Similarly, practices that (i) offer high-demand services (e.g., nephrology) and/or (ii) are experiencing difficulties finding and retaining qualified staff, have benefitted from this focused approach. These types of factors, along with other considerations such as space, technology, and staff training often result in high costs associated with in-house billing processes. Pinnacle’s experienced RCM team allows our clients to take advantage of our economies of scale, ultimately resulting in lower costs. In addition, our RCM services improve our clients’ compliance efforts as our team remains informed of regulatory changes which we use to regularly train staff and invest in necessary technology and software. Collectively, Pinnacle’s RCM team allows our clients to streamline billing processes in an effort to drive outcomes that are more accurate, efficient, and effective.
Pinnacle provides excellent customer services to our outsourced RCM clients with a knowledgeable and experienced team that includes accessible patient account representatives. Our goals in assisting our clients include higher collection rates, lower costs to collect, and improved profits. We use processes we have developed to drive success in revenue cycle and deliver outstanding financial results. By managing revenue cycle for large numbers of medical practices and hospital provider services, Pinnacle is a trusted partner that our clients rely on to deploy specialized knowledge and focus. Examples of the types of activities and focus areas we utilize to improve client in-house RCM operations include: