Collect More of the Revenue You've Earned.

Understanding the Operational Root Causes of Improve Collections

When cash collections lag behind clinical growth or wRVU production, the organization is experiencing silent margin erosion across charge capture, coding, payer adjudication, underpayments, or patient responsibility collection.

Improving net collections requires tracking every encounter along a Date-of-Service (DOS) 30/60/90/120-day cash waterfall against contracted payer fee schedules rather than relying on monthly posting-date cash summaries.

By reconciling signed EHR clinical notes, clearinghouse 837/277CA logs, 835 ERA payments, and point-of-service patient collections, leadership can pinpoint the exact stage where expected cash drops off.

• Date-of-service cohort cash waterfall analysis measuring actual cash collected vs. contracted allowable
• Encounter-to-claim charge capture reconciliation across clinic, hospital, and ASC settings
• Audit of non-contractual adjustments, bad-debt write-offs, and small-balance write-off thresholds
• Point-of-service copay/deductible capture and digital patient statement performance review

Financial Stakes: Cash Velocity, Net Yield & EBITDA Protection (M–M+ NPR)

Lifting Net Collection Rate by 250 to 500 basis points on a $20M–$80M healthcare organization generates $500,000 to $4M+ in direct annual cash flow and EBITDA.

When revenue-cycle friction compounds across multiple providers, facilities, or payer contracts, the financial damage shows up twice: first as uncollected cash and elevated Days in A/R, and second as inflated Cost to Collect from manual rework.

What Leadership Should Evaluate First: Forensic Diagnostic Checklist

Before restructuring internal billing teams, issuing an RCM vendor RFP, or purchasing new automation software, leadership should verify the underlying transaction data across the following diagnostic checkpoints:

• Date-of-service cohort cash waterfall analysis measuring actual cash collected vs. contracted allowable
• Encounter-to-claim charge capture reconciliation across clinic, hospital, and ASC settings
• Audit of non-contractual adjustments, bad-debt write-offs, and small-balance write-off thresholds
• Point-of-service copay/deductible capture and digital patient statement performance review

Common Mistakes Organizations Make When Addressing This Challenge

Healthcare operators frequently lose 6 to 12 months of momentum—and substantial working capital—by treating symptoms rather than fixing the upstream clinical, intake, or technical handoffs driving the problem.

• Measuring collections using gross collection percentage, which fluctuates with chargemaster inflation rather than true net yield
• Waiting until after insurance adjudicates to discuss deductibles and financial responsibility with patients
• Writing off aged or denied balances to clean up A/R reports without auditing collectibility

30/60/90-Day Advisory & Implementation Roadmap

RCM Advisory Partners structures engagements around clear, measurable milestones designed to protect cash flow during execution:

1. 01
   Days 1–30: Independent Baseline & Transaction Forensics

   Forensic baseline diagnostic of improve collections across 837 claims, 835 remittances, EHR workqueues, and payer contracts.

2. 02
   Days 31–60: Operating Model Design, Workflow Remediation or Partner Selection

   Execute targeted workflow, claim scrubber, coding, and vendor SLA remediation with weekly leadership checkpoints.

3. 03
   Days 61–90: Execution Oversight, SLA Stabilization & KPI Governance

   Verify net cash collection lift, aging reduction, and first-pass resolution gains and transition into ongoing KPI governance.