Healthcare

Revenue cycle management


Capitalize on our proven track record of exceeding expectations for financial clearance, coding accuracy, cash recoveries, and denial reversals

Revenue cycle management (RCM) requires dedicated resources for coding, prior authorizations, clinical denials, billing/collections, records management, and more. HGS has a proven track record of exceeding client expectations for financial clearance, coding accuracy, cash recoveries, and denial reversals. We have recovered more than $1 Billion in denied insurance payments for our provider clients. Our end-to-end revenue cycle management services include:

  • Eligibility verification
  • Prior Authorization
  • Financial Clearance Support
  • Medical Coding
  • Documentation and clinical reviews
  • Billing Platform Management
  • Denials Management and Appeals – clinical and administrative denials
  • Aged AR Resolution, Legacy AR Winddown
  • Early-out/Small Balance Claims Resolution
  • Specialty AR Management – Workers Comp; Motor Vehicle Accident; Third Party Liability
  • Payment Posting
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How we do it

Our suite of services includes front-end patient access services; mid-cycle charge integrity, medical coding, and billing services; and back-end insurance claims resolution offerings, administrative and clinical denial appeals, and customer-driven self-pay early-out services.

The value of HGS RCM services

The numbers speak for themselves.

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Accounts receivable

More than $6.9 billion in client accounts receivable are managed and $2.6 billion in cash recovered.

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Claims

We have processed more than 60 million hospital, physician, and DME claims.

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Denial reversal

We have reversed more than 8 million zero-paid denials, resulting in $950 million in recovered payments.

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Denial reversal on aged claims

Denial reversals and cash recovered on claims aged >1 year from discharge often cover cost of service.

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Cash recovery

Cash recoveries exceed client baselines by an average of +21%.

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Multi-source cash recovery

$3 billion in cash recovered, including $1.5 billion in denial reversals.

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Client satisfaction

100% of clients surveyed state that they would use HGS’s RCM services again.

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Our healthcare accreditations

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