Revenue Maximization Group
Improved Revenue Flow for Healthcare Organizations

Before Medicare declared new Chronic Care Management Codes in 2015-16, medical facilities struggled to maintain a steady flow of revenue due to their inability to effectively operationalize and make optimal use of the existing preventative coding structures set by Medicare. Consequently, both hospitals, as well as clinics, provided these preventative care services free of charge, in turn, experiencing a huge loss in revenue and providing a less then stellar patient experience. Summarizing Revenue Maximization Group’s (RMG’s) expertise in addressing this predicament, Stuart R. Miller, President and CEO discusses with CIO Applications, how the company helps healthcare institutions mitigate these challenges while creating a strong foundation, implementation strategy and successfully operationalizing a comprehensive preventative care management suite of services that enhances the patient journey while creating new recurring revenue streams without any new fixed costs.

How would you define RMG’s core competencies?

Since its inception, RMG has been making optimal use of the Medicare preventative coding structures in an ambitious bid to help healthcare organizations increase revenue and improve clinical outcomes. Right from RMG’s inception, we sensed a lack of understanding on how to implement and operationalize the preventative care services that Medicare is promoting. Additionally, through our ability to interrogate data we discovered a lack of accuracy in coding and inconsistent workflows, which resulted in a massive loss of revenue for healthcare facilities.

On the other hand, organizations have always struggled to apply Medicare preventative codes while treating patients with chronic ailments and providing preventive care to the patients successfully. RMG’s expertise in solving real-world healthcare problems allows these clinics and hospitals to maximize revenue in return. We offer Chronic Care Management & Annual Wellness Visits (AWVs) services, Transitional Care Management (TCM) Behavioral Health, (BHI) Remote Telemonitoring (RTM), Telehealth, Revenue Cycle Management, and Merit-based Incentive Payment System under the Medicare Access and CHIP Reauthorization Act (MACRA MIPS). With these solutions, our team strives to implement an end to the prevailing revenue leakage in the healthcare industry by offering a full-service, full-cycle, comprehensive holistic approach.

How does RMG’s suite of solutions address the industry challenges?

RMG is dedicated to helping healthcare firms contain costs, Improve productivity and enhance the quality of medical encounters.

Our experts have designed solutions specifically to implement and operationalize all of the preventive care services for patients, as well full revenue cycle management solutions. The RMG holistic approach allows us to agnostically look at any situation, create a set of solutions that are designed optimize workflow, eliminate redundancy and increase revenue through the preventative care service and revenue cycle chain within any healthcare organization.
RMG Preventive care service line is designed to baseline all patients as they enter the Medicare market, manager their chronic conditions utilizing a host of tools, thus mitigating expense and enhancing the patient journey. Additionally, our care coordinators are able to deploy various tools such as Transitional care management (TCM), Remote Telemonitoring (RTM), and Telehealth to reduce the unnecessary hospital readmissions thus reducing the potential penalties hospitals and facilities face. These tools allow the RMG Care coordinators to track the patients’ health conditions and help them maintain a healthy lifestyle and avoid unnecessary costs and stress within the healthcare journey.

In short, RMG has achieved the recognition of a patient advocate by deploying preventive care elements and tracking improvements for each patient in Medicare to ensure the best quality care. In addition, we also provide complete transparency between the patients, and all of their providers in the Electronic Medical records systems. We have a saying ‘Patients don’t get sick and don’t get well in the exam room, all of this happens outside the four walls of the facility.’ It is the RMG role to provide this visibility to the providers to facilitate the best possible patient treatment plans.

What makes RMG unique in the Healthcare Solution Space?

Although we cater to healthcare organizations such as hospitals and clinics, we also consider patients to be our customers. We act as an promoter of care between the doctors and the patient. RMG’s solutions set is designed to simply fit within the existing workflow while simultaneously reducing redundant activities, increasing efficiency in providing care, while generating new recurring revenue. The entire end-to-end process facilitates MACRA MIPS requirements and reduces workload; clients do not require any additional resources or costs in order to finish tasks. In the end, organizations reap benefits in terms of a recurring revenue stream and better patient care. Also, RMG assists organizations in reducing reimbursement leakage and providing best coding practices. Unlike most revenue cycle management companies, we address the root cause of every issue to mitigate the recurring problems or symptom treatment. RMG has been able increase collections, shorten cash flow cycles, submit clean claims and significantly reduce denials well below industry standard to all of its clients.

The entire process involves understanding pitfalls, areas of claim denials, and attacking directly at the root cause of the problem, in an effort to optimally manage the business RMG diligently tracks the key performance indicators (KPIs) above the national average which will achieve maximum revenue generation and cash flow.

How does the future look like for RMG?

We are in the process of being acquired by a company called Nexteligent, a holding company designed to acquire and manage technology-centric health and wellness companies with related but distinct products, services, markets, and opportunities. We look forward to becoming part of a public company that’s building a complete Senior Care solution set that is from inception through the entire lifecycle of the care continuum.