Protect Your Bottom Line: Ensure Compliance and Accuracy

In today's complex healthcare landscape, maintaining accurate and compliant documentation, coding, and billing is crucial to your organization's financial health.

Our team of experts can help. We offer comprehensive audit and education services tailored to your specific needs. Our AHIMA- and AAPC-certified consultants have deep experience in multi-specialty auditing, coding, and operations.

What we offer:

• In-depth Audits: We'll meticulously review your documentation, coding, and billing practices to identify areas for improvement.
• Targeted Education: Our tailored training sessions will empower your providers, management, and staff to stay up-to-date on the latest regulations and best practices.
• Expert Guidance: Our team will provide the insights and guidance you need to navigate complex regulatory landscapes with confidence.

Partner with us to:

• Strengthen Compliance: Mitigate risks and avoid costly penalties.
• Enhance Accuracy: Improve your revenue cycle and maximize reimbursement.
• Drive Operational Excellence: Streamline your processes and boost efficiency.

Additional Services:

• Independent Review Organization (IRO) services for corporate integrity agreements
• Coding and billing vendor audits

Let's work together to safeguard your organization's financial future.

Our professional fee audits range from $40-$75 per encounter, depending on a variety of factors. We’d love to learn more about you and your needs and customize a solution for your organization. Please complete the form and we’ll be in touch within 1-2 business days.
Service options to select from: Audit Only, Education Only, Audit & Education, Uncertain/Custom 

As the healthcare industry remains an active environment for mergers and acquisitions, navigating these complex transactions requires skilled expertise on both the buy and sell side. RubinBrown’s consultants bring critical insight into the financial health of healthcare organizations, with specialized focus on revenue cycle evaluation, accounts receivable, and third-party payor settlement positions.

When clients are ready to merge, acquire, sell, enter a joint venture, or partner, our team supports each phase—from due diligence through post-transaction integration. Working closely with transaction advisors and investment firms across the country, our consultants deliver clarity on financial, reimbursement, and payment-related challenges, providing invaluable guidance to support informed, confident investment decisions.

Our Transaction Advisory Services Include:

• Balance sheet review
• Reimbursement rate / cost of care analysis
• Assessment of reimbursement and revenue cycle policies and procedures
• Identify reimbursement risks and opportunities based on current and proposed regulations
• Evaluation of existing accounts receivables, including aging and bad debt statistics
• Valuation of third-party payer settlement receivables/payables
• Regulatory scan, assessing the current regulatory and reimbursement environment and identifying potential changes that could have an impact
• Contract assessment, including guidance on payer strategies and negotiation support
• Review of internal controls, compliance processes and procedures for coding, claim creation, submission and payment posting, validating adherence to all applicable guidelines
• Review of remittance advice, low-paid claims, and denied claims to determine root causes, patterns, and breakdowns responsible for the denials.
• Certificate of Need legislation evaluation

Healthcare Provider Documentation & Coding Education Services: Our platform, RubinBrown Provider Education Portal, delivers documentation and coding education to empower compliant revenue growth through expert documentation and coding training and offers flexible and affordable pricing options to meet the needs of your organization and providers. Learn more.

Defending Your Revenue: Expert Audit Response and Appeals

Navigating the complex world of payer audits can be daunting. With increasing scrutiny from Medicaid, commercial payers, and other external auditors, healthcare organizations need a strong defense strategy.
At RubinBrown, we're here to help you protect your revenue and minimize financial risk. Our experienced team will:

• Thoroughly Analyze Audit Findings: We'll meticulously review audit findings, assessing the potential for successful appeals.
• Provide Expert Guidance: Our team leverages deep knowledge of official coding references, regulatory guidelines, and payer-specific policies to provide strategic advice.
• Craft Compelling Appeal Letters: We'll develop persuasive appeal letters that highlight the strengths of your claims and address the auditor's concerns.
• Support You Through the Entire Appeal Process: From initial responses to higher-level appeals, we'll be with you every step of the way.

Our Services Include:

• In-depth Chart Reviews: We'll analyze patient charts to identify potential issues and gather supporting documentation.
• Coding and Documentation Expertise: Our team will ensure that your claims are supported by accurate and compliant coding and documentation.
• Leveraging Regulatory Guidelines: We'll utilize LCDs, NCDs, CPT® codes, and CMS resources to strengthen your appeal.
• Drafting Persuasive Appeal Letters: We'll craft compelling arguments that address the auditor's concerns and maximize your chances of success.

Don't let payer audits erode your revenue. Partner with RubinBrown to safeguard your financial health.

 

Bridge the Gap: Interim Leadership Solutions for Healthcare

Navigating periods of transition or staffing shortages can disrupt your healthcare organization's revenue cycle. At RubinBrown, we provide experienced interim leaders to bridge the gap and ensure seamless operations.

Our interim leaders bring:

• Deep Expertise: Our professionals are skilled in all aspects of revenue cycle management, including patient access, billing, coding, and collections.
• Proven Track Record: We have a history of delivering results, improving financial performance, and enhancing operational efficiency.
• A Focus on Compliance: We'll ensure your organization adheres to all relevant regulations and industry standards.
• A Commitment to Process Improvement: We'll identify opportunities to streamline your processes and reduce costs.

Whether you need short-term support or a strategic overhaul, we'll provide tailored solutions to meet your specific needs.

Let us help you:

• Maintain Continuity: Ensure uninterrupted operations during times of transition.
• Drive Financial Performance: Optimize your revenue cycle and improve your bottom line.
• Enhance Operational Efficiency: Streamline processes and reduce administrative burdens.

Partner with RubinBrown to ensure your revenue cycle is always in capable hands.