SOLUTIONS

Revenue Cycle

The Trilogy team of experienced revenue cycle professionals can help improve and optimize every aspect of the revenue cycle, from scheduling and registration, to final claims resolution. The scope of our revenue cycle engagements is tailored to fit the needs and maximize opportunities for each client.

The Revenue Cycle process is multi-disciplinary and substantially impacts every aspect of healthcare operations and finance. In today’s rapidly changing healthcare environment, combined with increased reimbursement pressures, it is more critical than ever to ensure maximum performance in every aspect of the revenue cycle.

Trilogy offers expertise in operational optimization, quality and financial controls, broad-scale efficiencies and proven best practices.

PEOPLE, SERVICE AND PRODUCT ARE WHAT WE FOCUS ON AT TRILOGY REVENUE CYCLE SOLUTIONS.

Closeup of a medical professional typing on a keyboard. A stethoscope sits in the foreground.

EXPERTISE

Trilogy Revenue Cycle Solutions will engage with the client and facilities’ revenue cycle leaders, to provide long-term process improvement initiatives, short-term targeted areas of opportunity, or focused industry best practice education. Trilogy is committed to “winning” with your team or providing outsourcing options. The scope and cadence of our revenue cycle engagements are tailored to fit the needs of each client. Trilogy’s services include, but are not limited to, the following:

  • Pre-Service
  • Point of Service Collections
  • Improvement
  • Eligibility/Benefits Determination
  • Accuracy
  • Complete Orders
  • Denial Reduction
  • Error/Edit Resolution
  • Regulatory Requirements (ABN, MSPQ)
  • Education
  • Concurrent Review 
  • Authorizations 
  • Denials Management • Swing Bed 
  • LOS Management 
  • Transfer DRG Review 
  • Clinical Documentation  Improvement  
  • Medical Necessity 
  • Physician Education
  • Charge Entry
  • Coding
  • CCI Edits
  • Clinical Documentation Improvement
  • Medical Necessity
  • DNFB Management
  • RAC Audits
  • Education
  • Master Index Files
  • Work Queue Functionality
  • 837, 277, 835 Processess
  • ERA, EFT Processing
  • Conversion Project Assistance
  • Interface Integrity
  • Decision Support Reporting
  • Charge Master
  • Unbilled Account Management
  • Claims Management
  • AR Resolution
  • Payment Posting
  • Remittance Management
  • Denials Management
  • Vendor Management
  • Legacy AR Projects
  • Billing System Optimization
  • Contract Review
  • Managed Care Strategy
  • Provider Enrollment Process Review
  • Reimbursement Analysis Improvement
  • Key Controls
  • Communication
  • Collaberation
  • Accountability
  • Goal Setting
  • Teamwork Development
Patient Access Management
  • Pre-Service
  • Point of Service Collections
  • Improvement
  • Eligibility/Benefits Determination
  • Accuracy
  • Complete Orders
  • Denial Reduction
  • Error/Edit Resolution
  • Regulatory Requirements (ABN, MSPQ)
  • Education
UTILIZATION REVIEW/ CASE MANAGEMENT
  • Concurrent Review 
  • Authorizations 
  • Denials Management • Swing Bed 
  • LOS Management 
  • Transfer DRG Review 
  • Clinical Documentation  Improvement  
  • Medical Necessity 
  • Physician Education
HEALTH INFORMATION MANAGEMENT
  • Charge Entry
  • Coding
  • CCI Edits
  • Clinical Documentation Improvement
  • Medical Necessity
  • DNFB Management
  • RAC Audits
  • Education
SYSTEMS OPTIMIZATION
  • Master Index Files
  • Work Queue Functionality
  • 837, 277, 835 Processess
  • ERA, EFT Processing
  • Conversion Project Assistance
  • Interface Integrity
  • Decision Support Reporting
BUSINESS OFFICE
  • Charge Master
  • Unbilled Account Management
  • Claims Management
  • AR Resolution
  • Payment Posting
  • Remittance Management
  • Denials Management
  • Vendor Management
  • Legacy AR Projects
  • Billing System Optimization
MANAGED CARE
  • Contract Review
  • Managed Care Strategy
  • Provider Enrollment Process Review
  • Reimbursement Analysis Improvement
LEADERSHIP DEVELOPMENT
  • Key Controls
  • Communication
  • Collaberation
  • Accountability
  • Goal Setting
  • Teamwork Development

SOLUTIONS

REVENUE CYCLE OVERSIGHT AND OPTIMIZATION TEAM (RCO)

SCOPE OF SERVICES:

  • Revenue Cycle Optimization
  • Project Management
  • Subject Matter Experts

TRILOGY BUSINESS OFFICE (TBO)

SCOPE OF SERVICES:

  • Revenue Cycle Optimization
  • Project Management
  • Subject Matter Experts
  • Claims & AR Management
  • Payment Posting
  • Conversion Claims Management
  • Legacy AR Clean UP
A photo of a person working with data, an illustration of a bar chart is overlaid onto it.

ASSESSMENT APPROACH

Trilogy will perform a high-level assessment of the revenue cycle to include organizational structure; operations; on-site assessments of patient and staff process flows; and one-on-one interviews with key personnel. Additionally, Trilogy will review data to assess the overall effectiveness of revenue cycle processes and identify opportunities for optimization. This process will include efforts to identify both short- and long-term opportunities that will help the system achieve synergies throughout the healthcare system and improve financial performance.

SUBJECT MATTER EXPERTS

Provide Revenue Cycle Subject Matter Experts for all facets of the Revenue Cycle

COLLABORATIVE ENGAGEMENT

Trilogy team members work closely with Client teams to drive collaboration through the assessment process

KEY PERFORMANCE

Compare Client Key Performance Indicators to Best Practice Standards

OPERATIONS

Compare Client Operations to Best Practice Standards

FINANCIAL OPPORTUNITY

Develop Financial Opportunity Analysis

S.H.A.R.P STRATEGY BOOK

Trilogy will provide the client with actionable prioritization of revenue cycle initiatives based on findings

EXECUTIVE SUMMARY

Develop Executive Summary with findings and recommendations. Onsite presentation and discussion of findings and opportunities.

OVERSIGHT AND

OPTIMIZATION TEAM

Trilogy Revenue Cycle Solutions will engage with the client, and facilities’ revenue cycle leaders, to provide revenue cycle oversight with the purpose of identifying and implementing viable options to optimize revenue cycle management; improve operational efficiency and effectiveness; maximize cash flow; and enhance overall financial results

TEAM DYNAMICS

TEAM FOCUS

• System Optimization
• Policy Development
• Communication Optimization
• AR Aging Reduction
• Cash Collection to Goal
• Metric Reporting
• Process Optimization
• Clean, Timely Claims
• Denials Management

PROJECT MANAGERS

• On Client Site Each Week
• Initiative Identifier and Driver
• Detail Oriented
• Facilitator
• 10+ Years in Director Level Roles

SUBJECT MATTER EXPERTS

• Defined area of expertise in which they provide assistance as needed on various projects

SITE SUPPORT SPECIALIST

• Detail oriented
• Analytical
• Root Cause Determiners
• Process Flow Developers
• 5-10 years in Revenue Cycle Roles

TEAM FOCUS
  • System Optimization
  • Policy Development
  • Communication Optimization
  • AR Aging Reduction
  • Cash Collection to Goal
  • Metric Reporting
  • Process Optimization
  • Clean, Timely Claims
  • Denials Management
PROJECT MANAGERS
  • On Client Site Each Week
  • Initiative Identifier and Driver
  • Detail Oriented
  • Facilitator
  • 10+ Years in Director Level Roles
SUBJECT MATTER EXPERTS
  • Defined area of expertise in which they provide assistance as needed on various projects
SYSTEMS OPTIMIZATION
  • Detail oriented
  • Analytical
  •  Root Cause Determiners
  • Process Flow Developers
  • 5-10 years in Revenue Cycle Roles

PROJECT MANAGERS

Trilogy will provide a Project Manager to lead all onsite efforts and initiatives

SUBJECT MATTER EXPERTS

Trilogy will provide Revenue Cycle Subject Matter Experts for all facets of the Revenue Cycle

COLLABORATIVE ENGAGEMENT

Trilogy team members work closely with Client teams to drive process improvement throughout the Revenue Cycle

KEY PERFORMANCE

Trilogy team works with Client to prioritize projects to measure and improve Key Performance Indicators to Best Practice Standards

OPERATIONS/SYSTEMS OPTIMIZATION

Trilogy team works with Client to prioritize operational needs to move Operations to Best Practice Standards and ensure systems are optimized

S.H.A.R.P STRATEGY BOOK

Trilogy will provide the client with actionable prioritization of revenue cycle initiatives based on findings

EXECUTIVE SUMMARY

Deliver Weekly and Monthly Executive Summaries and Dashboards to track client and engagement performance

A man in a suit and a woman in a doctor's coat are looking at a computer monitor.

BUSINESS OFFICE TEAM

SCOPE OF SERVICES

Billing cycle “end-to-end” solution to promote operational efficiency and
effectiveness; maximize cash flow and enhance overall financial results.

CLAIMS MANAGEMENT

Claim processing to include claim creation, claim submission, billing edits, clearing house edits, and payor reject resolution.

PAYMENT POSTING

Payment posting for paper EOBs and ERAs. Reconciliation with deposits.

ACCOUNTS RECEIVABLE MANAGEMENT

Initiate payor follow-up, work with payors to claim resolution, and generate
next responsible party claims.

DENIALS MANAGEMENT

Collaborate with Client to report, repair and rebill denied claims. Work with
client to eliminate future denials.

CODING MANAGEMENT

Initiate payor follow-up, work with payors to claim resolution, and generate next responsible party claims.

TEAM DYNAMICS

Senior Director

— 10+ years in Director Level Roles
— Detail Oriented
— Facilitator
— Initiative Identifier and Driver

Billing Specialist

— 3+ years in Billing and Collections
— Task Oriented

Manager

— 10+ years in Manager Level and Above Roles
— Detail Oriented
— Inventory and Metric Driven

Team Focus

— Clean Claims
— Timely Claims
— AR Aging Reduction
— Cash Collections to Goal
— Denials Management

Lead Billing Specialist

— 5+ years in Billing and Collections
— Detail Oriented
— Analytical
— Root Cause Determiners

Interested in what Trilogy can do for your facility?