How Veradigm Revenue Cycle Services (RCS) Can Help Boost Practice Financial Health
Written by: Marianne Gregson, RCM Principal Client Success Manager, Veradigm, and Cheryl Reifsnyder, PhD
Today’s healthcare practices face numerous challenges that can make successfully navigating the end-to-end revenue cycle more difficult than ever. Changing reimbursement models and evolving government requirements make it difficult to stay current with the latest standards for claim submissions. Meanwhile, recruiting and retaining medical practice administrative staff is increasingly difficult, resulting in staff shortages that place additional pressure on your existing team.1
Many practices are struggling to maintain a healthy revenue cycle without compromising their primary goal of delivering high-quality patient care.
Veradigm Revenue Cycle Services (RCS) was created to help practices overcome these and other challenges. Keep reading to learn how Veradigm RCS, with its team of professional billing experts, can boost the financial health of small and independent medical practices.
Veradigm Revenue Cycle Services (RCS)
Veradigm RCS is an end-to-end revenue cycle solution, an administrative and financial management solution designed to optimize financial performance for medical practices and physician groups. We bring a comprehensive approach to revenue cycle management, a combination of people, processes, and technology working together to improve your accounts receivable and improve practice productivity and efficiencies.1
- PEOPLE: Our professional billing experts partner with your practice at every step of the revenue cycle to help ensure accurate billing and coding.
- PROCESS: We utilize best practices throughout the entire revenue cycle continuum, from operational planning to scheduling, to final collections and reporting.
- TECHNOLOGY: A solid technology stack provides a comprehensive, rules-based engine to automate tasks, streamline workflows, and improve cash flow; including an analytics toolset to identify trends and deficiencies in the revenue cycle; and technology to monitor, track, and respond immediately to any issues affecting financial or operational performance.
This comprehensive approach enables Veradigm to help practices maximize revenue, boost efficiency and productivity, increase cash flow, and improve their bottom line.
4 Routes to better financial health
Veradigm RCS can help you improve your revenue cycle from multiple points simultaneously. Here are a few key routes Veradigm RCS targets to help improve your practice’s financial health.
1. Keeping up with complex reimbursement requirements
Veradigm RCS can help your practice stay current with complex, changing reimbursement requirements, including the transition to value-based care. Doing so helps your practice increase billing and coding accuracy and process more claims, which, in turn, results in fewer claim denials.1
2. Account management with advanced analytics
Veradigm RCS provides the expertise to maximize the use of analytics and the Veradigm technology suite, while your practice retains complete financial control. Real-time access to advanced analytics provides complete transparency into the billing cycle and offers deeper insight into your practice’s financial health.1 Our expert team provides best practice recommendations based on analytics-derived insights. We work closely with your practice to maximize revenue by utilizing trend and comparative analysis to monitor ongoing performance, enabling you to reduce underpayments and missing charges.1
3. Resolution of inefficient billing workflows
Veradigm RCS creates a process to implement change and unlock the full revenue potential of your practice. We ensure results by optimizing the entire revenue cycle, starting with scheduling and registration assistance at the initial point of patient contact. Guided scheduling and task automation help you to maximize your practice schedule. Integrated eligibility and authorization verification at the start of the revenue cycle helps increase speed to payment down the line.1
4. True denial management
A recent survey from the Medical Group Management Association found that 60% of medical groups experienced higher rates of claim denials in 2024 compared to the previous year. However, over 90% of denials are preventable. Veradigm RCS provides true denial management, identifying and addressing recurring denials, providing root cause analysis of denials, and sorting denials according to error type (billing, coding, or front office errors). The result? Our clients achieve an average first-pass clean claims rate of 99%.
Driving revenue improvements
With over 30 years of experience, Veradigm RCS has worked with more than 24,000 providers in more than 35 specialties. Managing $4.2 billion in payments annually , Veradigm RCS provides results that drive revenue and improve financial health, including:
- 98% first-pass clean-claims rate
- 96% net collections
- 3% to 5% revenue improvement*
Such results take on greater meaning when seen in the context of the actual practices where Veradigm RCS has made a difference, such as the Clinics of North Texas.
Clinics of North Texas
The Clinics of North Texas, one of the largest independently owned group practices in the Texoma region, is a network of over 35 physicians in 15 medical specialties. The Clinics’ combined network handles 250,000 patient visits a year. Their 200 employees include 20 in-house staff who are engaged in billing and collection workflows.
However, the Clinics faced significant challenges with in-house revenue cycle management. Their heavy reliance on manual processes for revenue cycle management contributed to substantial inefficiencies. This resulted in a primarily retroactive focus, dealing with denials and waiting on appeals. The constant need to collect on outstanding balances prevented them from effectively managing the Clinics’ revenue cycle.
The Clinics had developed a close partnership with Veradigm, using Veradigm solutions, over the past decade. Although the leadership group explored a variety of revenue cycle services offerings, the Veradigm team was the only one that seemed to understand the Clinics’ needs. It made sense for them to expand their relationship to include Veradigm’s Revenue Cycle Services offering.2
The result of this expanded collaboration? They implemented a new revenue cycle management strategy, which enabled them to simplify their business operations and improve collections.
Their successful outcomes included:
- A 20% revenue increase in the first year
- A 67% reduction of days in A/R, from an average of 30 to 10 days
- A reduction of A/R over 90 days from 56% to 16%
- An increase of gross collection rate by 1.64%
Working with Veradigm RCS also significantly reduced the administrative burden for the Clinics’ staff.
As a result of their success with Veradigm RCS, the Clinics of North Texas received the 2021 Better Performers Award from the Medical Group Management Association (MGMA) in the Operations category.
Invitation to learn more
Veradigm RCS is unique among revenue cycle management offerings in its flexible customized service approach. Clients can choose services to match their specific needs, from comprehensive outsourcing, which enables practices to virtually eliminate their billing office and repurpose or reduce their full-time staff; to short-term billing help; to a shared co-source option. Our revenue cycle management team includes experts with a broad range of specialty expertise, providing expert collaboration to maximize your revenue potential.
Veradigm RCS is also not limited to practices using Veradigm solutions. Veradigm RCS has expertise working with multiple 3rd-party platforms, picking up where your current platform stops.
Healthcare practices today face a growing number of staffing, operational, regulatory, and other challenges that make successful revenue cycle management increasingly difficult. Do any of the following describe your practice?
- Your practice struggles to maintain a healthy revenue cycle while still providing quality patient care.
- The struggles faced by the Clinics of North Texas mirror challenges faced by your practice.
- One or more of the challenges listed in the sidebar—staff shortages, industry and regulatory changes, and so on—is interfering with effective revenue cycle management.
If the answer to any of these questions is “yes,” we invite you to reach out today. Contact Veradigm and learn more about how collaboration with our billing and coding experts can help your practice overcome current revenue cycle challenges and maximize your revenue potential.
Footnotes: *Average results after first 12 months. Results may vary. Veradigm Data on File, April 2025. **Veradigm data on file, April 2025.
References:
- Veradigm, 2023. Veradigm Revenue Cycle Services – Data Sheet. VDMP-848-1.
- Veradigm, 2023. Clinics of North Texas Client Profile. VDMP-1121.