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  • Writer's pictureNate

Revenue Cycle in Crisis

In times of (financial) crisis, revenue cycle leaders need to look for new revenue opportunities.

The healthcare revenue cycle is in the midst of an unprecedented crisis, at a level that will be unknown for quite some time. The COVID-19 pandemic has thrown physician practice and hospital revenue into a path of unpredictability and volatility. Parts of healthcare systems are overwhelmed with inpatient volumes, while other areas of healthcare delivery - like elective surgeries - are basically shut down. Volumes and payor mix should normalize at some point, but none of us know when. In the meantime we have volatility and uncertainty. We have limited control of new revenue coming in as the pandemic (and response to it) are basically calling the shots for healthcare provider revenue at this point.

So what do we, as healthcare revenue cycle leaders, do in this time of revenue cycle crisis?

Looking for missed revenue opportunities and finding leaked revenue, while always important, has never been so critical to revenue cycle success. (I can just hear one of the Executive Directors of Revenue Cycle saying, "Duh. But where am I going to find the people to do that at a time like this and how am I going to pay for it?"

How confident are you that your payors are paying you correctly on all of your billed services, every time?

The Switch AI platform was developed to quickly process and analyze large amounts of data and identify variations in payment patterns and issues in charging patterns. It was developed as a billing-system agnostic tool for identifying under payments.

Because of the strains on revenue cycle operations right now, Switch is offering healthcare providers a no-risk opportunity for a payment integrity audit.

Provide us with your 835 files, and ideally your commercial payor contracts, and we will use the Switch AI platform to perform an automated payment integrity audit. Even if you are using a contracts tool today - in your billing system or from a healthcare technology vendor - it is worth taking a look. If we find no variation in payment and no issues with charging patterns, you will be able to answer the question I posed with certainty, and it costs you nothing but the time spent sending the files. If we find problem-indicating payment variations, we can work with you to find the root cause, identify the recovery opportunity and provide data needed for submitting bulk appeals.

Contact us today at if you are interested in a risk-free payment integrity audit.


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