Revenue Cycle Management and Managed Care Leaders Council Save a Total of $67,096,659 Million Over Four Years

The VHA Georgia Revenue Cycle Management and Managed Care Leaders Council increased revenue over $67 million between 2006 and 2010. They accomplished this by sharing knowledge and best practices, which members would then apply at their individual hospitals and health systems. This allowed them to capture more revenue, providing the most significant value.

Another way the council increased revenue was by negotiating agreements with companies that provided exceptional, high-value services and products in revenue cycle management.

By incorporating both strategies, the Council increased their combined revenue/savings impact by focusing on high dollar issues such as:

• Reduction of denied claims through improved Denials Management policies and practices
• Increased revenue through recoveries of underpayments or non-payment due to payer issues
• Revenue capture through process improvements at the “front end” such as enhanced cash collection techniques and eligibility determination
• Preparing for and avoiding major Recovery Audit Contractor (RAC) issues
• Education on managed care payer tactics for delaying or denying hospital claims Conducting chargemaster updates and working closely with the charge producing departments Working with Phoenix regional agreement partners such as Integrated Revenue Management, Triage Consulting and Nemadji Research Corporation

As a result of these process improvements including charge audits, lost revenue and reimbursement recovery, management of appeals and denials, recouping underpayments and filing second level appeals, VHA Georgia members improved revenues by $13,229,517 in 2010. The Council was recognized for this achievement by winning the 2010 Continued Excellence Award. This is the second award for them, as they won the Outstanding Council of the Year Award in 2005. In total, the VHA Georgia Revenue Cycle Management and Managed Care Leaders Council has documented $67,096,659 in value.

By winning these awards and offering unique educational and networking opportunities, the VHA Georgia Revenue Cycle Management and Managed Care Leaders Council has seen increased participation by members and will continue to strive for excellence.

For more information, please contact Michael White, Vice President Development and Operations at 770.850.7406 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .