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Professional Services

Most healthcare organizations don’t require lengthy consulting engagements that can last for a week or more. This is especially true when the outcome is a one-time, temporary boost to the balance sheet that is offset by exorbitant consulting fees. Fortunately, Excalibur takes a different approach to professional services.

In an industry that is data-rich but intelligence-poor, we ground our consulting services in proven analytics. We partner with you to teach, support, and drive data- and metric-driven principles to manage your organization. Such a light and agile approach to consulting, supported by advanced analytics, results in a sustainable relationship with the client at the center, enjoying behind-the-scenes support from the entire Excalibur team.

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Interested in becoming an Excalibur client, or just need assistance?
Give us a call at 877-505-1454, or contact us here »
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”Bridge Support”

Between Finance and Revenue Cycle

AR Valuation and an Eye on the Financials

As an industry thought leader on Reserves and AR Valuation, Excalibur sits on the bridge between Finance and Revenue Cycle, closing the education, communication, and priority gaps that exist between the two functions. This translates into a supercharged understanding by Excalibur leaders and staff regarding the impact of Denials on the Contractual Budget, why Allowances must be monitored and not “wobble around,” and why CFOs hate “surprises” even more than a down Cash month. Instead of just clicking through accounts, Excalibur is managing “to the Net Value” of the AR, which is a far different orientation than any other vendor in the outsourcing space.

Excalibur provides:

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AR Valuation and Reserves

Consulting Services

AR Valuation and an Eye on the Financials

As an industry thought leader on Reserves and AR Valuation, Excalibur sits on the bridge between Finance and Revenue Cycle, closing the education, communication, and priority gaps that exist between the two functions. This translates into a supercharged understanding by Excalibur leaders and staff regarding the impact of Denials on the Contractual Budget, why Allowances must be monitored and not “wobble around,” and why CFOs hate “surprises” even more than a down Cash month. Instead of just clicking through accounts, Excalibur is managing “to the Net Value” of the AR, which is a far different orientation than any other vendor in the outsourcing space.

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Dispositional

Attempting to manage the AR “one by one”, or by “Balance and Age” results in a frustrating, futile process for the Revenue Cycle Team as they can never get their arms around volumes and can’t ever quite touch ‘the right accounts at the right time with the right strategy”. Excalibur assists Clients in combatting this industry problem through a radical commitment to segmenting both the AR and the Account Representative’s work periods using methods that categorize and companionate accounts so that significantly higher volumes are resolved with fewer efforts.

The art of ‘not touching an account’

By leveraging predictive analytics, Excalibur consistently studies opportunities to only touch accounts requiring manual intervention. This helps staff unclog inflated worklists and dramatically increases Cash by penetrating the pools of AR that actually need their efforts for resolution

Data Driven

Excalibur lives Data Driven Decision Making and Performance Management as part of its work culture. Their role is to tell their Client Partners the story of the AR; “How Much? How Fast? What Remains? And Why?”

AR Valuation and an Eye on the Financials

As industry thought leaders on Reserves and AR Valuation, Excalibur sits on the bridge between Finance and Revenue Cycle, closing the educational, communication and priority gap that exists between these two functions. This translates into a supercharged understanding by Excalibur leaders and staff regarding the impact of Denials on the Contractuals Budget, why Allowances must be monitored and not ‘wobble around’ and why CFOs hate ‘surprises’, even more than a down Cash month. Instead of just ‘whipping through accounts’, Excalibur is managing “to the Net Value” of the AR, which is a far different orientation than any other vendor in the outsourcing space.

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Payer Level Income Statement Publication

Waiting for month end is too late. As is providing feedback to the Revenue Cycle on key line items on the income statement that require improvement such as Contractuals and Bad Debt Expense. Moreover, the Top Line View by Facility or Enterprise limits the Team on knowing ‘where to attack’.

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To address this business problem, Excalibur creates a Payer Level income statement that is executed more frequently (bi-monthly, weekly or daily as desired), essentially performing a ‘month end close at any time, at a deeper level’ to reduce surprises and allow Finance and Revenue Cycle to influence the Income Statement outcomes ‘before they happen.’

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Business Intelligence and Analytics Roadmap

Our organization is adaptive and “with the times” in utilizing business intelligence, artificial intelligence, robotics process automation, digital patient engagement and other technology-based techniques and key business drivers. We offer a solution via our channel partner to enhance your organization or can use your preferred systems and your ideas to train and equip your team to engage and succeed more efficiently in an industry that is moving further away from paper and singular phone calls each year.

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Merlin, The Complete Lean Consulting Package.

Merlin aggregates Acute, Ambulatory, Call Center data, and Third Party data sources into one centralized hub that helps unify the revenue cycle team (from Pre Processing all the way through to Bad Debt vendor management) and connects rev cycle to Finance.

Merlin empowers the Team to “slice and dice” and carve up the AR with unlimited dimensions and perspectives to find pockets of Cash, reshape the Receivable and quickly cleanse the AR of uncollectibles.

Call Center production statistics are published from and housed in Merlin.

Examining The Whole Data Picture.

The Team executes a No Surprises Campaign and models Income Statement impacts on Bad Debt and Denials (Contractuals) weekly. Whether the news is favorable or unfavorable, the Team “knows the story” and can rapidly collaborate with Finance and moreover, change strategy on the fly to change outcomes.

Total Touches per Rep per Day are measured.

Results Oriented vs “kicking the can down the road” touches are measured.

Business Intelligence and Analytics Roadmap | Excalibur

FHN Leads The Industry In Revenue Cycle And Finance “One Team, One Objective” Collaboration.

FHN committed to a Business Intelligence/Big Data or analytics driven revenue cycle approach in 2007 or before.

Before the en vogue industry terms that are now common place today were in circulation, FHN was already piloting or implementing these principles. Single Version of the Truth – FHN committed to ending disparate reporting sources for solving complex business problems several years ago and launched Merlin to consolidate all data, wherever possible, into one software solution. FHN uses analytics to join Hospital and Financial data to provide a “supercharged” Guarantor view (ie, consolidating Pay Plans and Self Pay follow up routines) of the Accounts Receivable.

Predictive modeling is used to understand how to approach patients regarding Financial Assistance, extended Pay Plans or creative solutions to complex high balance scenarios.

FHN manages the AR by Disposition (the underlying story of where an account sits in its life-cycle) and not just by Age and Balance.

The DNFB Has Been “Best In Class” For Years And Years.

The Rev Cycle Team views the DNFB as another segment of the AR and not “us vs HIM”.

In this regard, there is daily segmentation, feedback loop reporting and actionable target setting to reduce and sustain best practice levels of Discharged Not Final Billed.

The DNFB is managed by Key Ratios instead of static targets.

Delayed Cash Due to DNFB Beyond Suspense by Payer is measured Daily.

The coding output target adjusts directionally with volumes.

HIM Leaders receive ongoing mentorship on the back-end of the rev cycle and greatly understands their impact. This simply does not occur elsewhere.

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Cash Targets are set at a FC level.
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Cash is managed at a Facility and FC level.
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All Leaders convene to strategize around Cash on a disciplined, ongoing frequency.
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Director and VP Mentorship Service

If your organization has a position that needs to be filled while you search for the perfect permanent hire, we can provide the ideal interim leader. Instead of just filling the role, Excalibur provides a leader who implements our Merlin Lean Consulting approach and analytics, actively engages in recruiting for the permanent candidate, and provides the full benefit of his or her professional experience along the way.

Excalibur offers interim leadership services for the following positions:

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  • CFO
  • Controller
  • Decision Support
  • VP / Executive Director, Revenue Cycle Operations
  • Revenue Cycle Systems and Controls
  • Director, Patient Financial Services
  • Director, Patient Access
  • Director, HIM

Staff augmentation for all staff and mid-level leadership rolls within Patient Access, Patient Financial Services, Finance and Decision Support.

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Month-End Packet Preparation

Each month designated team members will receive a personalized branded packet.

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  • Executive Dashboard
  • Vendor Scorecard
  • Command and Control
  • Payer Target Setting Guide
  • Cash Targeting Insights
  • Revenue and Claims
  • Key Processing Ratios
  • Days Indicators
  • Contractuals and Denials
  • Uncompensated Care
  • Active Receivables
  • Aged Receivables
  • Dispositional Receivables
  • Allowances Monitoring
  • Payer Scorecard
  • Inpatient
  • Outpatient
  • Final Billed Ratio Data
  • Revenue Cycle Income Statements
  • Dispositional Receivable
  • Allowances Monitoring
  • Totals
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Daily, Weekly, Monthly Reporting and “Push Analytics”

Excalibur believes consistency is key in ensuring that targets are met, but meaningful targets must be established first. We assist the organization in determining targets from multiple scientific standpoints (both leading and lagging). Additionally, we report performance to target at the financial class level on a strict morning-time schedule which allows leaders to plan for their days/weeks/months and to avoid “surprises.”

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Pillars, Methods, and Tactics Hardwiring for Excellence

No project or day in the revenue cycle should be managed “as it occurs” and must have a component of organization and tactic to ensure ultimate efficiency. Excalibur offers five pillars and seven methods to attack your organization’s issues from an organized and efficient standpoint, which allows the team to spend more time focusing on the number one goal of every revenue cycle organization: cash.

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For Health Care Finance and Revenue Cycle leaders, most initiatives and projects, as well as day to day operational challenges, can be deconstructed into the following pillars. By asking the following “business imperative” around each pillar, excellence can be hardwired and continuously improved and sustained.

STRUCTURE (org chart, key revenue cycle stakeholders)

Does the organizational chart, along with external vendors and partnerships, support the Provider’s business objectives?

PEOPLE (training, job descriptions, skill-set to position alignment, mentorship)

Are Skill Sets Aligned? Are job descriptions clear and reflective of current responsibilities?

Are staff and leadership aligned on strategies and tactical approaches? Is staff properly trained?

PROCESS (strategies and tactics)

Are policy statements and desk procedures in place and used? Are processes based upon business objectives? Are processes clearly defined and communicated? Are cross-functional process maps available for each major process?

TECHNOLOGY (enablers to Best Practice processes; Patient

Payment Estimator, BI, maximizing the host platform etc.) Does Technology enable Process or is Process defined/limited by Technology?

Are technology enablers implemented and operationalized to support People and Process?

MEASUREMENT (Key Performance Indicators, creating a daily metric driven culture)

Are Key Leading and Lagging Performance Indicators used on a daily, weekly and monthly frequency to manage performance? Is the culture metric driven?

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Comprehensive Revenue Cycle Redesign Services

Radical Commitment to Defect and Exception Driven Performance Management Approach

Excalibur helps clients live by Key Leading and/or Key Relational Indicators that create an intense focus on managing what “didn’t happen”, pinpointing on variances and volatility, and making only the most strategic touches during the business day

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Method Driven

Excalibur uses proven methods, such as Dispositional Receivables Management, to create a playbook that aligns the organization and takes our discipline of touching the right accounts and the right time with the right strategy to new heights.

Holistic View

Excalibur sees beyond the departmental view of the revenue cycle and uses a cross-disciplinary view, including all functional areas directly involved with the rapid, compliant conversion of Gross Revenue into Cash. This often includes Scheduling, Pre-Processing, Care Management, Patient Access, HIM, Revenue Cycle Systems and Controls, along with Patient Financial Services.

Interconnectivity

Additionally, an increasing burden is placed on revenue cycle leaders to be intimately involved in; Net Revenue and A/R Valuation topics, Revenue Integrity, Compliance, Systems and Decision Support. To this end, the structure must support interaction, liaison, or management of these functional processes within the larger context of healthcare financial management.

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Contract Negotiation

Excalibur supports Provider contract negotiation through a triangulation exercise that “looks back, looks at, looks forward”:

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Analyzes Payer Contract historical performance

  • Against “itself” (ie Aetna historical performance)
  • Against other Payers (ie Aetna compared to Blue Cross)

Analyzes Payer Contract performance against “perfection” (the modeled net revenue from the provisions of the Contract)

  • Against itself
  • Against other Payers

Produces powerful Payer Scorecards that help determine:

  • How much Net Revenue was “left on the table” by underperforming contracts or –
  • How much opportunity or yield was possible if “Aetna had a more favorable contract like Blue Cross”
  • Why are cycle times so much slower on the same procedure for Blue Cross vs Aetna?
  • Blue Cross contract terms are more favorable, but their Denial % nullifies the lift in terms compared to Aetna
  • Enables powerful “if then scenarios” and
  • Postures the Provider to make data driven decisions about negotiating more favorable terms and ensuring Payer accountability

In addition to preparing the triangulation studies and scorecards, Excalibur can provide consultative support to actually engage the Payers and renegotiate Managed Care contracts.