Revenue Cycle Management
With most healthcare organizations having razor thin margins, a small disruption to your revenue cycle can be catastrophic. We help organizations enhance every aspect of the revenue cycle by improving people (organizational structure and resource allocation), processes, and technologies.
The result is a healthy revenue cycle that supports a strong performing organization and enhances overall patient and provider experience.
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Revenue Cycle Management Services
LBMC is here to support your healthcare practice and healthcare organization’s goal of enhancing financial performance while operating in a compliant environment.
The breadth of our resources allows us to effectively support clients across the entire revenue cycle including
- front (patient access, denial management),
- middle (charge capture, pricing, documentation, coding, revenue integrity, denial management) and
- back (billing, accounts receivable resolution, denial management, vendor management).
Benefits:
- Enhanced Net Revenue
- Increased Efficiency / Reduced Cost
- Enhanced Customer Service
- Reduced Risks
- Improved Employee Satisfaction
Engagement Scope:
- Small Engagements: specific issues or departments
- Large Engagements: revenue cycle transformation, system selection & implementation
Services:
- Performance Improvement
- Revenue Cycle Integration
- Transformation
- Technology Implementation Support
- Resource Support
- Interim Leadership
- Complex Project Management
- Reporting & Benchmarking
- Business Change Enablement
Case Study: National Hospital System Revenue Cycle Vendor Assessment
One of the nation’s largest health systems, operating hospitals across rural and underserved communities, utilized a fully outsourced revenue cycle model supported by two vendors. As concerns around billing accuracy, operational efficiency, and compliance increased, leadership sought an independent assessment to evaluate vendor performance and identify opportunities for improvement.
Our Approach
LBMC was engaged to conduct a comprehensive revenue cycle and compliance assessment across six hospital facilities. The engagement included on-site evaluations, workflow observations, leadership interviews, vendor performance benchmarking, financial opportunity analysis, and coding and compliance reviews. LBMC independently assessed both vendors and compared their performance against national standards.
The Outcome
LBMC provided leadership with an objective view of vendor performance, identified operational and compliance improvement opportunities, and delivered actionable recommendations to optimize revenue cycle operations. Armed with quantitative rankings, financial insights, and strategic guidance, leadership was able to make informed decisions regarding vendor management, performance improvement, and future revenue cycle strategy.
Frequently Asked Questions
How can a healthcare organization improve its revenue cycle performance?
Improving revenue cycle performance requires more than fixing isolated issues. High-performing organizations evaluate the entire revenue cycle, from patient access and insurance verification through coding, claims management, denials, billing, and collections. Many organizations also benefit from independent assessments that identify workflow inefficiencies, technology gaps, and staffing challenges before they affect financial performance.
If your challenges extend beyond revenue cycle operations, our Healthcare Consulting Services provide broader strategic support across compliance, operations, financial performance, and organizational transformation.
When should a healthcare organization consider revenue cycle consulting?
Healthcare organizations often seek revenue cycle consulting when they experience:
- Increasing claim denials
- Rising accounts receivable
- Declining cash flow
- EMR or billing system implementations
- Staffing shortages
- Vendor performance concerns
- Mergers or acquisitions
- Declining patient satisfaction related to billing
Whether you need a targeted assessment or a full revenue cycle transformation, an experienced advisor can help identify root causes and prioritize improvements.
Why is the revenue cycle so difficult to enhance and transform to achieve best practice performance?
Improving the revenue cycle can be difficult given the overall complexity and linkage of all revenue cycle functions. This complexity is due to various factors. Firstly, the healthcare industry has a multitude of payers, including government programs, private insurers, and self-pay patients, each with their own reimbursement rules and requirements. Additionally, coding and billing practices are highly intricate, requiring accurate documentation and adherence to numerous coding guidelines. The evolving regulatory landscape adds further complexity, as providers must navigate changing reimbursement policies and compliance standards. Furthermore, the vast amount of patient data, fragmented information systems, and the need for interoperability pose challenges in streamlining processes and ensuring seamless data flow. Moreover, the increasing patient financial responsibility, with high deductibles and copayments, demands effective patient communication and robust financial policies. To overcome these complexities, healthcare organizations must adopt advanced technologies, implement efficient workflows, and prioritize continuous staff training and compliance.
Complex revenue cycle operations require a multitude of specialists and subject matter experts that can be trusted to help you make the right decisions. Our deep bench of revenue cycle, financial, operational and clinical personnel allow us to bring the right resources to you.
What RCM Metrics You Should Care About?
The most valuable RCM metrics change based upon provider type and other factors. Broadly, we believe the following to be among the most important to measure, monitor and use for course correction. Healthcare organizations should monitor several key metrics to assess the effectiveness of their revenue cycle management. Here are some important metrics that they should pay attention to:
- Collections as a Percentage of Net Revenue: This metric measures the cash collected as a percentage of net revenue and is typically calculated using a net revenue lag period.
- Denial write-offs as a percentage of net revenue: This metric uses actual write-offs necessitated by denials as a percent of net revenue and is used to benchmark overall denial management performance.
- Initial Denial Rate: This metric uses the total initial denied charges as of percentage of total charges submitted and allows for assessment of overall denial management efficiency.
- Bad Debt as a Percentage of Net Revenue: This metric is calculated by using bad debt write-offs as a percentage of net revenue and is used to benchmark bad debt management performance.
- Cost to Collect: This metric matches overall revenue cycle cost with collection amounts and helps determine how efficient the revenue cycle is.
- Aged Accounts Receivable (A/R) as of Percentage of Billed A/R: This metric highlights how long it takes to adjudicate claims and identifies “at risk” A/R balances.
- Insurance Verification Rate: This metric reflects to what level patient access functions are timely, accurate and efficient. It is the total number of verified encounters over the total number of registered encounters.
- Days in Discharge Not Final Billed (“DNFB”) A/R: This metric is the total DNFB divided by average daily revenue. The days in DNFB should be approximately the number of established bill hold days.
- Late Charges as a Percentage of Total Charges: This metric helps evaluate revenue capture efficiency and is calculated as the charges with a post date > established days from date of service over total gross charges.
- Days Revenue in Credit Balance: This metric helps evaluate the effectiveness of credit balance management and is the total A/R credit balances divided by average daily revenue.
- Patient Satisfaction: While not strictly a financial metric, patient satisfaction plays a crucial role in revenue cycle management. Satisfied patients are more likely to pay their bills promptly and engage in positive financial interactions, reducing the risk of bad debt or collection challenges.
Monitoring these metrics regularly and comparing them against industry benchmarks can help healthcare organizations identify areas for improvement, track performance over time, and implement strategies to enhance revenue cycle management.
What should I look for in a health care advisor?
It is obvious that any advisor should have the deep technical expertise and experience to help you solve issues. As important, you should have an advisor that you enjoy working with and helps foster the right culture. Large transformation projects, and even those smaller in scale, require working through difficult issues and frequently working long hours. Our team at LBMC takes pride in our collaborative and positive approach to helping our clients.
Can revenue cycle consulting improve denial management?
Yes. Denial management is one of the largest opportunities to improve financial performance.
Rather than simply appealing denied claims, effective revenue cycle consulting identifies why denials occur, whether from registration errors, authorization issues, documentation gaps, coding inaccuracies, or payer-specific requirements.
Organizations looking to strengthen coding accuracy may also benefit from our Coding & Compliance services, while reimbursement strategy issues may require Reimbursement Consulting.
How does revenue cycle management support healthcare financial performance?
Revenue cycle management directly affects cash flow, reimbursement, operating margins, and patient experience.
When registration, documentation, coding, billing, collections, and denial management work together effectively, healthcare organizations can:
- Improve net revenue
- Reduce cost to collect
- Shorten accounts receivable days
- Reduce write-offs
- Improve patient financial experience
- Create more predictable cash flow
Because revenue cycle performance touches nearly every operational area, many organizations address it as part of a broader Hospital & Health System Advisory or Healthcare Consulting engagement.
Expert Insights
- Revenue Cycle Management in Healthcare: 2026 Guide
Revenue cycle management in healthcare is the foundation of financial health. LBMC explains its process, benefits, and proven optimization strategies. - Key Strategies to Strengthen Revenue Cycle Services
Navigate the U.S. healthcare landscape with guidance for CEOs and CFOs. Enhance financial health and patient outcomes through revenue cycle management. - Contractual Allowance vs. Bad Debt for Healthcare Providers
Knowing the difference between contractual allowance and bad debt is critical to healthcare providers. Learn why proper classification matters. - The Crucial Role of Accurate Cost Reports in the Healthcare Industry
Learn why accurate healthcare cost reports matter for Medicare reimbursement, policy decisions, benchmarking, and reducing reporting risk. - Four Key Considerations for the Future of Healthcare Financial Management
Discover key considerations every healthcare CFO must address, including reporting, automation, compliance, and financial management. - 4 Key Financial Metrics for Physician Practice Success
Monitor the financial metrics that improve collections, reimbursement performance, and the long-term financial health of physician practices. - ARH’s Success in Automating Insurance Claim Denial Resubmissions
See how ARH improved efficiency, reduced manual work, and increased revenue collection by automating insurance claim denial resubmissions. - Top Reasons to Prioritize Healthcare Operational Efficiency
As patient demand grows and reimbursement pressures continue, discover practical ways healthcare organizations can improve operational performance. - Value-Based Reimbursement and Contracting – No Margin, No Mission
Learn why health systems and physician groups should prepare for value-based reimbursement models and evolving payment structures. - How VDA Can Boost Your Hospital’s Revenue
The Volume Decrease Adjustment (VDA) offers crucial financial support to eligible hospitals experiencing significant reductions in patient discharges.
Local Expertise, Wherever You Are
With offices in Chattanooga, Memphis, Louisville, Nashville, Knoxville, Philadelphia, and Charlotte, plus remote offices, LBMC partners with businesses across the region and beyond.
LBMC Revenue Cycle Management Team
Let’s Talk About Your Healthcare Organization
Whether you’re navigating regulatory challenges, improving financial performance, or planning for growth, LBMC’s healthcare team is ready to help. We’ll start with a conversation focused on your organization’s goals, current priorities, and where you need support.