Eligibility and authorization gaps
Services delivered without a valid authorization or verified coverage often can't be billed at all.
Healthcare Revenue Cycle Management
Revenue cycle visibility from first authorization to final payment.
Whether billing is done in-house or by a billing company, we review and reconcile each step of your revenue cycle, so you know where revenue is delayed, reduced, or lost.
- CPA-overseen
- Completely remote
- Works with the systems you already use
The challenge
Revenue leaks at the handoffs
Each step of the revenue cycle is usually owned by a different person or system. Revenue is lost where one hands off to the next.
Charges that never become claims
Missed or late charge capture means work that was done but never billed.
Denials that are written off instead of worked
Without a clear view of denial reasons, the same problems repeat every month.
Payments that are posted but never checked
Underpayments and incorrect adjustments are easy to miss when payments are posted without being reconciled.
What we do
Revenue cycle consulting and oversight
Eligibility & authorization review
Coverage and authorizations checked against the services you deliver.
Charge capture review
Delivered services compared to charges and claims to find unbilled work.
Denial analysis
Denials grouped by reason and payer so the root causes can be fixed.
Payment & remittance reconciliation
Remittances matched to claims, adjustments, and deposits.
Revenue cycle KPIs
Days in A/R, denial trends, and collection performance reported monthly.
Workflow improvement
Practical fixes to handoffs between intake, billing, and posting. Using HHAeXchange? Try our free workflow assessment.
Technology & reconciliationHow our technology works
Every step of the cycle, connected
We connect scheduling, EVV, EHR, practice management, clearinghouse, billing, and accounting data, then reconcile each stage of the revenue cycle so gaps show up as exceptions instead of write-offs.
Your billing staff or billing company keeps its current tools. You get independent visibility into the results.
Systems we connect
- Scheduling & EVV
- EHR & practice management
- Clearinghouses
- Billing platforms
- Accounting software
- AuthorizationsServices delivered
- Services deliveredClaims billed
- BillingActual payments
- ClaimsRemittances
- RevenueActual cash collected
We confirm which connections are available for your systems before you commit.
Business outcomes
What a healthier revenue cycle looks like
- Fewer services delivered without authorization or coverage.
- Unbilled work found and billed while it's still collectible.
- Denial root causes fixed instead of repeated.
- Underpayments identified and followed up.
- Monthly revenue cycle reporting leadership can trust.
Example scenario
Tracing one service through the revenue cycle
Authorized
We confirm the service had valid coverage and authorization before it was delivered.
Delivered and billed
We check that the delivered service became a charge and a clean claim, on time.
Paid
We match the remittance to the claim and confirm the payment and adjustments are correct.
Recorded
We tie the payment to the bank deposit and the general ledger, and flag any gap along the way.
An illustration of how an engagement typically works, not a specific client's results.
FAQ
Frequently asked questions
Do you do our billing for us?
Our focus is oversight and reconciliation: reviewing and reconciling the revenue cycle your in-house team or billing company runs, and helping fix the gaps we find. Ask us about your situation during a consultation.
Which healthcare organizations is this for?
Home health and hospice agencies, physician practices and medical groups, pharmacies, skilled nursing facilities, and other healthcare organizations with payer billing.
What revenue cycle measures do you report on?
Typically days in accounts receivable, denial trends by reason and payer, collections compared to billing, and aging by payer, tailored to your organization.
How long before we see results?
It depends on your systems and the condition of your data. We'll outline a realistic timeline after the initial assessment.
Find out where your revenue cycle is leaking
Talk with YCA Healthcare about an assessment of your revenue cycle, from authorization to final payment.