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Revenue Integrity Solutions

SunStone appreciates the unique problems faced by every healthcare provider and understands the challenges of continuing to provide quality care while remaining financially viable. SunStone’s approach to each engagement is to combine our specific technical expertise and experience with the operational and technical knowledge of the provider’s personnel involved in the revenue cycle process.

SunStone utilizes best practices, key performance indicators, and results reporting to help healthcare providers achieve targeted results while not compromising the delivery of care to your consumers. We work collaboratively with management and staff, who are faced with innumerable financial, clinical and operational challenges, to develop an effective and comprehensive process that will produce long term results. Our objective is to assist our clients ensure adherence to regulatory requirements while also quantifying revenue optimization that can be gained from process improvements.

Our experience extends to hospital providers, health systems, free standing facilities, behavioral health providers, as well as physician and non-physician extenders.

Revenue Cycle Process Improvement Solutions

Proactive diagnostic review of the scheduling, pre-registration/registration, documentation, charge capture and billing processes to ensure adherence with governmental guidelines and appropriate revenue generation for the facility.
Assistance identifying barriers hindering providers from achieving compliance and optimal revenue capture in the delivery of specific clinical services.
Development of formal work plans which identify opportunities for improvement including revision of policies and procedures, process improvements in interdepartmental communication and staff education.
Educational programs deliverable in a format deemed appropriate for the specific audience targeted.

Project Management Solutions

SunStone understands the challenges that can be encountered and the complexity involved in a billing system conversion and is attune to measures that will ensure organizations remain financially viable. SunStone assists providers assess the impact conversions have on registration, billing, accounts receivable and net revenue and assist providers identify systemic issues within a hospital organization that can impact on a successful billing system conversion.

Contract Negotiation & Compliance

SunStone assists clients manage the contract process to ensure that payers are meeting their commitments and are receiving optimal reimbursement based on predetermined goals and strategies.

For detailed information about SunStone Consulting Revenue Cycle Solutions, please contact
Vonda Moon (vondamoon@sunstoneconsulting.com).

Charge Process (CDM)

Compliance

Documentation Accuracy Program

Outpatient Claim Analysis

Pharmacy Revenue Cycle

Pricing

Reimbursement & Financial Analysis

Revenue Integrity Solutions

Transfer MS-DRG Review

Workers’ Compensation Recovery

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