Healthcare Performance Improvement

Revenue Cycle Improvement

FORVIS understands the pressures your business office and revenue cycle departments endure. Our experienced pros can bring insight and innovative approaches to help identify opportunities for excellence in revenue cycle operations. FORVIS’ approach to revenue cycle improvement provides end-to-end services that can help organizations improve revenue yield. Not only can we assess for opportunities, but our team has the depth, knowledge, and experience to transition assessment opportunities all the way through to implementation.

Our services include:

• Revenue Cycle Assessment
• Accounts Receivable Management
• Denials Prevention & Management
• Denials Management Monitoring Digital Solution
• Patient Access
• No Surprises Act Compliance
• Pre-/Post-System Implementation Support
• Revenue Cycle Organizational Design & Staffing
• Patient Liability Strategies
• Revenue Cycle Vendor Management
• Cash Posting
• Coding & Documentation Improvement (CDI)
• Charge Description Master (CDM)
• Strategic Pricing & Transparency
• Charge Capture
• Coding & Billing Compliance
• Managed Care Contracting

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Clinical & Operational Excellence

FORVIS' team of clinicians, physician advisors, and prior hospital executives help clients drive care forward to identify and implement clinical and operational improvements through data-driven assessments, benchmarking, design, and implementation efforts. Our consultants help organizations improve performance and patient outcomes through:

• ED Fine Tuning
• Utilization Review & Case Management (UR/CM)
• Length of Stay Management
• Patient Statusing
• Surgical Services Calibration
• Service Line Strategy & Performance
• Physician Practice Management

Cost Management

Increasing demands for an efficient workforce must be rigorously managed and continually challenged. However, patient care needs should not be compromised when determining staffing requirements and contractual labor arrangements. Productivity should be monitored, understood, and improved for continued financial success moving forward.

High performers know that continued investment in nonlabor cost reduction is a critical and productive investment. While inherently difficult to manage, areas such as GPO, supplies, purchased services, and capital investments are great sources for year-over-year margin improvement. With the right strategy, skills, and investment, even high-performing organizations can see bottom-line improvement equal to as much as 1.5–3% of net patient service revenue.

Our healthcare consultants are ready to help position your provider organization for cost management success.

CDI & Coding Compliance

Clinical documentation integrity (CDI) and coding professionals play an important role in both fee-for-service and fee-for-value reimbursement models by ensuring that the services provided to patients accurately reflect their unique medical severity. FORVIS coding and documentation professionals work with healthcare providers to help improve clinician engagement, develop policies and procedures, streamline internal processes for data collection, perform external coding and documentation compliance assessments, and provide education and training on CDI and accurate coding processes.

Payor Strategies & Services

Contract rates negotiated with payors in your local market are critical to healthy margins. Determining whether you’re being paid fairly requires benchmarking and an understanding of best practices prior to successful contract negotiation. FORVIS has access to both commercial and Medicare paid claims nationwide to help with benchmarking efforts.

Reaching an agreement with a payor about services and rates requires preparation, data analysis, and strategic negotiation. FORVIS will help determine if your organization is well positioned with major payors in the market and help you develop a road map to improve payor relationships. We can help with:

• Benchmarking
• Modeling
• Payment Audits
• Best Practices
• Negotiations

Physician Services

FORVIS’ team of physician enterprise consultants has the background, know-how, and modern skill sets necessary to help drive performance excellence. We have a front-to-back assessment approach spanning many areas, including payor contracting, reimbursement strategies, patient throughput, charge capture, revenue cycle, cost management, and provider compensation design.

340B

Staying up to date with ever-changing regulations and meeting increasing demands from providers, patients, payors, and regulators can be daunting for pharmacy leaders. FORVIS' professionals understand these pressures that you’re facing. That’s why our services are tailored to help you enhance financial performance, remain compliant, and assess cost-saving opportunities so you can focus on providing innovative, effective, and valuable medicines to your patients.

• 340B Compliance
• 340B Program Development & Calibration
• 340B Co-Sourcing
• Provider-Based Billing
• Pharmacy Expansion
• Pharmacy Structure
• Opioid Assistance

Healthcare Analytics

The healthcare industry is flooded with data. However, data without context is neither valuable nor actionable.

FORVIS believes that valuable data should be able to help you execute strategies and drive meaningful change. Our team focuses on providing clients with the right information at the right time. We leverage our experience in data analysis to create powerful, technologically advanced data visualization products, models, and dashboards that help users quickly and intuitively understand and analyze complex data sets. In addition, our tools and checklists include best practices that can be incorporated into daily operations.