Unleashing Revenue Potential: Innovative Solutions for Hospital Financial Success

Article originally published in Becker’s Healthcare

Healthcare organizations have long struggled to manage complex revenue cycles, from tracking down payments to ensuring compliance. They are increasingly realizing the need to partner with revenue integrity experts who can help them capture appropriate reimbursement for services provided.

“Many hospitals depend on a high volume of case reviews and outsourced staffing models,” says Jay Ahlmer, President of Corro Clinical, part of CorroHealth. “We have created a flexible model to work with hospitals to find the correct blend of outsourced support and internal staff empowerment to drive improved performance with hospital leaders in the driver’s seat.”

Corro Health has leveraged the expertise, technologies, and capabilities developed by combining two revenue integrity leaders: CorroHealth and Versalus Health, to form Corro Clinical. Corro Clinical’s efforts have resulted in over two billion in compliant revenue recoveries for providers since 2016, with an average of 30 days to see results.

It’s an effort that requires clinical and financial leadership, data integrity, a holistic view of the revenue cycle and a deep knowledge of payer behavior to understand what drives underperformance.

A Data-Driven, Clinically Led Approach With No Conflicts of Interest

While many players in the revenue cycle management space are focused on solving transaction-related issues, Corro Clinical is provider-centric, with no relationships with payers. This commitment allows them to support provider partners unreservedly and execute strategies across the organization without conflicts.

It’s common for insurance companies and other payers to create obstacles that make it challenging for healthcare service providers to receive payment for services. Corro Clinical offers a data-driven solution by utilizing insights across massive datasets to establish a benchmark evaluation and compare performance across various payers. The proprietary program enables the team to identify where revenue cycle problems occur and take the necessary steps to address them.

But analyzing data requires understanding the context. To achieve this, Corro Clinical partners with its clients to assess current practices and develop strategies to improve performance.

“We understand the market trends that impact every hospital, and the challenges can be unique. Creating an approach that addresses universal trends and that is customized for local challenges is our strength,” says Ahlmer.

Corro Clinical’s methods bridge the gap between clinical care and back-end operations. They work with healthcare organizations to create a comprehensive and strategic revenue-recovery plan that addresses its unique concerns, driving internal change and restoring financial health for healthcare operations.

“We listen carefully to understand our client’s concerns, and then apply our experience, immense datasets and proprietary programs to create a customized solution”, says Ahlmer. “By helping hospitals compliantly capture appropriate reimbursement for services and putting them in a financially stable position, we pave the way for the best possible care,” says Jay Ahlmer, President of Corro Clinical.

Empowering Healthcare Organizations in Revenue Recovery

Corro Clinical has revolutionized the revenue cycle management process by empowering healthcare organizations to take control of their financial health, reducing reliance on outsourced help. They provide a unique program that empowers teams through a strategic partnership, offering customized solutions to support clients’ vision. A key aspect of the program is education. The healthcare team undergoes targeted training where knowledge gaps are identified. Corro Clinical then leads them through specialized education programs instructed by subject matter experts.

Corro Clinical employs an overarching strategy to recover revenue by detecting gaps and connecting relevant transactional processes contributing to final payment. Ongoing monitoring and auditing identify patterns of irregularities that can lead to finding lost revenues, a critical step in the continuous optimization of clinical revenue cycle operations and maintaining compliance with payer regulations and reimbursements. Ongoing monitoring and auditing of client practices verify accuracy in coding documentation, billing, payments, and collections data. This service ensures that hospitals and other providers accurately and ethically collect reimbursement for care.

Corro Clinical’s analytics are actionable and designed to improve client workflows for maximum efficiency, accuracy, and profitability. Such solutions enable them to build relationships with payers who can create sustainable payment models for better outcomes for the providers. By delivering a strategic plan and tactical advice based on data, the company ensures the program is holistic, meeting the client’s evolving needs.

“We are your partner, your advocate, and an extension of your team. Let us ensure you realize the revenue you are entitled to for the important care you provide,” says Ahlmer