The Revenue Cycle Management Technology Adoption Model (RCMTAM)

    RCMTAM offers healthcare providers a comprehensive tool to evaluate and enhance financial and technological performance through an evidence-based, five-stage maturity model.

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      Plot a course toward forward-thinking innovation that improves efficiency, the patient experience and your bottom line.

      Case Study
      A/R Optimizer

      Prospect Medical Benefits From 300-500 Fewer Denials Per Month With A/R Optimizer

      Business issue

      Prospect Medical grew very quickly from 10 to 17 hospitals and had many different patient accounting systems, billing systems and other vendor software products. To manage the strain of growth, Prospect sought solutions to enhance workflow and analytics, and to consolidate data across the organization.

      Before FinThrive

      Legacy systems failed to capture a comprehensive and accurate picture of claim denials

      Denials not tied to contract management process

      False positives, duplicate denials and secondary insurance issues

      Lack of consistent reporting definitions and methodologies across facilities


      Solution Highlights

      A true remaining balance using expected contractual amount and detecting denials

      Payer scorecards to facilitate better negotiation with payers

      Reimbursement analyzer to review what’s left at a line-item level

      Underpayment and denials management


      Customer Overview

      Prospect Medical Holdings is a significant provider of coordinated regional healthcare services in Southern California, Connecticut, New Jersey, Pennsylvania and Rhode Island

      FinThrive Value


      Reduced inpatient denial rate from 17.2% to 13.6%


      300-500 fewer denials per month for outpatients


      One facility benefited from $10 million less denied dollars than the previous year

      “In the past, if we had three or four out of ten denials that were false positives, the teams would lose focus on prevention efforts as they start assuming they’re going to see false positives that are not actionable. When we can identify real denials with real dollars at risk, there is an imperative and an energy to fix the underlying issues.”

      Ryan Bayne
      Corporate Vice President, Systems & Analytics

      Revenue management without limits

      FinThrive provides smarter, smoother revenue management to 3,250+ healthcare providers in North America, including 37 of the 40 largest hospitals and health systems in the U.S.

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