Project Overview

Service Provided: Revenue Cycle Management (RCM) Optimization and Automation

The client, a group of assisted and skilled nursing communities, partnered with S.K.I.L.L. Consultants to transform their revenue cycle operations. Our goal was to streamline every step—from patient intake through payment—by introducing better controls, process clarity, and automation that reduces payment delays and denials.

Objective

The healthcare group faced inconsistent cash flow and mounting aged receivables due to inefficiencies in billing, documentation, and claims follow-up. They sought a partner who could bring structure, automation, and accountability to their revenue cycle process—enabling steadier collections and improved financial visibility.

Challenges

Managing the revenue cycle across multiple care facilities presented several challenges:

• Fragmented processes between intake, coding, and billing teams.
• Frequent denials due to incomplete documentation and missed authorizations.
• Delayed claims submissions and inadequate follow-up on unpaid balances.
• Lack of real-time visibility into cash flow and receivables.

The task for S.K.I.L.L. Consultants was to rebuild the revenue cycle framework end-to-end, define control points, and apply automation to eliminate manual gaps and inconsistencies

Solutions Implemented

1. Comprehensive Revenue Cycle Mapping:
   We documented every step of the intake-to-payment journey—covering eligibility verification, authorizations, coding, documentation, claims submission, and payment follow-up.
2. Process Standardization:
   Standard operating procedures (SOPs) were created to ensure consistent execution across all facilities, reducing variability and human error.
3. Automation of Status Checks & Reminders:
   Automated tools were deployed to monitor claim statuses, send alerts for pending follow-ups, and flag potential denials before they occurred.
4. Training & Performance Tracking:
   Staff were trained on revised workflows and performance metrics were integrated to ensure accountability at each step.

Results

• Faster Collections: Cash collections became more predictable and timely, with smoother month-end closing cycles.
• Reduced Aged Receivables: Outstanding receivables over 90 days dropped significantly, improving overall liquidity.
• Improved Claim Accuracy: Fewer denials and resubmissions due to better documentation and automated verification.
• Enhanced Operational Efficiency: Automation reduced manual tracking time, allowing staff to focus on higher-value tasks.
• Sustained Financial Stability: The client now operates with steady cash inflows and fewer revenue surprises.

Impact Summary

Conclusion

By rebuilding revenue cycle controls and embedding automation at critical stages, S.K.I.L.L. Consultants enabled this healthcare group to achieve a sustainable financial rhythm. The engagement not only stabilized cash flow but also gave leadership greater confidence in forecasting and decision-making—turning the RCM process into a true strategic asset.