What does a strategic revenue cycle work plan look like?

For most medical practices, the business plan and the revenue cycle operate in separate silos. One gets updated regularly; the other runs on autopilot until something breaks.

Kem Tolliver, CEO of Medical Revenue Cycle Specialists, wants to change that. Tolliver works with health care organizations to build strategic revenue cycle work plans that are deliberately tied to broader organizational goals and she says the practices that do it well treat their revenue cycle not as a back-office function but as a living part of their business strategy.

Physicians Practice: When you say 'strategic revenue cycle work plan,' what does that look like in real life?

Kem Tolliver: The way I envision a strategic revenue cycle work plan is the alignment of all of your revenue cycle priorities with your overall business plan. It's fascinating when Taya and I conduct this workshop, because we're usually working with folks who do not oversee a revenue cycle but are the COO or CEO of a health care organization. It gives them insights into the activities we want to align within their revenue cycle departments for the entire organization.

What that looks like is internal auditing. What are you auditing? You're auditing your denials, your cash flow, inefficiencies, your documentation, and the processes your team is using to manage relationships with payers. That's what a strategic revenue cycle work plan looks like at its core.

But I also like to break it down by quarter. You can't eat an elephant in one bite. You have to take it one piece at a time. So I break that work plan down by quarter. In the first quarter, for example, you want to think about what's really important right now. We have new codes. We want to look at our fee schedules, our contracts, and audit our credentialing. The goal is to align that work plan with the overall business plan. Many health care organizations, and medical practices in particular, developed their business plan years ago, and health care has evolved so much since then. We want to make sure the revenue cycle work plan reflects where the organization is going.