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Hospitals and health systems are facing operational and financial challenges due to labor and resource shortages, shrinking reimbursement, increasing technology costs and the push to implement automation.
Established in 2002, PwC's Revenue Cycle Managed Services offer revenue cycle solutions, including standalone point solutions and customizable full-function outsourced services. PwC specializes in providing business process services across various functions (patient access, financial clearance, coding, insurance billing/follow-up and self-pay collections) for hospitals, medical groups and payers in a surge, partial or full-function outsource capacity.
Learn how we can support your extended business. Watch our video.
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Learn more about how we support your extended business
Best in KLAS
With an emphasis on quality, PwC’s Revenue Cycle Managed Services was recognized as being #1 in KLAS’ independent review for Extended Business Office Services in 2011, 2014, 2017, 2018, 2021, 2022 and 2023.
We've out-ranked our competitors as rated by consumers, in terms of satisfaction of services provided and exceeding expectations more months than any other vendor for the last thirteen years.
We focus on addressing your biggest challenges
Today’s issues faced by revenue cycles leaders:
- Managing high volumes of data to drive decision-making
- Preparing to consistently upskill workforce to match future capabilities
- Evolving from a work queue-driven model to an adaptable, predictable and automated model with analytics as a backbone
- Staffing shortages and high turnover rates
- Low availability of qualified or experienced staff
We help improve your business outcomes
Automation and artificial intelligence
Aim to deliver cost-effective, high-quality outcomes by leveraging claims status, automated note entry, telephony AI, accounts prioritization powered by machine learning and process mining.
AR Command Center performance reporting
Provide unparalleled transparency through our secure online portal, AR Command Center, allowing your leaders to see the overall performance of your A/R inventory at any given time. We offer a variety of views, filters and data points to enable complete transparency and collaboration among our teams.
A global workforce to deliver value across the revenue cycle
Serve nationwide clients of all shapes and sizes across 100+ facilities and professional settings, using a global workforce to deliver value across the revenue cycle. We bring together solutions that span strategy through execution to help you manage and operate your core business functions.
Issues logs and root cause trending
Share insights and trends to help you fix systemic issues that are increasing your days in A/R. We do all this through our JIRA enabled issues logs and weekly project health check meetings.
Complimentary accounts receivable analytics
Offer a no-cost analysis of your A/R using our proprietary tools as a first step to understanding opportunities related to your accounts receivable.
Our offerings
PwC's Revenue Cycle Managed Services team has onshore and offshore staff ready to support you with a suite of services customized to your needs.
- Legacy accounts receivable run-down
- Staffing backfill
- Analytics
- Full outsourcing/managed services/end-to-end revenue cycle
- Financial clearance (insurance verification, prior authorization, etc.)
- Coding support
- A/R follow up
- Denials management
Legacy accounts receivable run-down
We can help manage your legacy run-down, while your team focuses on new EMR (electronic medical record).
Staffing backfill
Our trained staff can step in and cover the revenue cycle spectrum, if you’re experiencing staffing challenges.
Analytics
Our data analytics team can provide comprehensive analytics to help you identify performance and payer issues.
Full outsourcing/managed services/end-to-end revenue cycle
We have both onshore and offshore staff covering the full revenue cycle continuum, and can work to build the team that best fits your needs.
Financial clearance (insurance verification, prior authorization, etc.)
Our onshore and nearshore representatives can work with your patients and payers prior to appointments.
Coding support
We can support you with production coding or coding denials.
A/R follow up
We have a trained team ready to assist you with all of your A/R needs, including small balance, aging, hospital and professional.
Denials management
We provide comprehensive denials management including a team of certified coders, nurses and data analytics.
A virtual workforce that delivers efficiencies for your organization where you need it most.
What makes Revenue Cycle Managed Services unique?
PwC is a professional services firm that is committed to the individual success of each client.
- 20+ years experience
- Best in KLAS results, consistently ranking among the top providers for extended business office services
- Scalability for any size project with access to a large pool of on- and offshore resources
- Internally developed technology and automation, leveraging the latest tech and automation, including automated note entry, accounts prioritization powered by machine learning and process mining
- Consultative wrap around approach, embedding consultants to optimize people, process and technology
- Significant experience working with third-party payers, including Medicaid and Medicare
Our technology
Resolution Queue
For many years, our automated work-driver tool has been utilized in the healthcare industry, as well as for third-party accounts receivable remediation and various other business processes.
Resolution Queue, the proven work-driver tool designed specifically for healthcare third-party accounts receivable remediation. This cutting-edge workflow software enhances the distribution and tracking of A/R assigned to staff, resulting in increased cash collections and improved account resolution. With the added feature of Instilling Quality, a monitoring tool that objectively scores accounts, follow-up activities are ensured to be effective. Whether used together or separately, these tools offer customizable work queues, comprehensive workflow reporting, and an unwavering focus on quality to drive superior outcomes. Benefit from our collaboration with healthcare providers and unlock the full potential of Resolution Queue to optimize your revenue cycle management.
Instilling Quality
Our dynamic quality assurance tool that monitors work quality and automates flagging for added support.
Experience the power of Instilling Quality, a dynamic quality assurance tool that objectively selects and scores follow-up activities on accounts. Whether used alone or with Resolution Queue, it ensures thoroughness and completeness in every account. With customizable criteria and personalized scoring, track your performance and drive better results. Elevate your healthcare accounts receivable remediation process with Instilling Quality today.
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