Client
( New York, USA)
Industry
Engagement
A large hospital system in New York engaged BTCNXT.AI to assess its Revenue Cycle Management (RCM) operations and lead a transformation initiative focused on reducing revenue leakage, improving operational efficiency, and accelerating cash flow.
Summary
The organization was experiencing significant coding and claim submission backlogs, manual workflows, limited performance visibility, and ineffective denial and accounts receivable management processes. These challenges were contributing to delayed reimbursements and substantial revenue risk.
BTCNXT conducted an onsite assessment, facilitated executive strategy workshops, and partnered with operational leaders to implement targeted process improvements and performance management frameworks.
Problem Statement
Key challenges included:
- Six-month coding backlog with approximately 10,000 encounters pending review
- Delayed claim submissions creating timely filing risks
- Revenue leakage from coding and billing inefficiencies
- Manual and redundant workflows across departments
- Limited visibility into denials, AR performance, and operational KPIs
- Lack of structured denial management and AR follow-up processes
The Solution
BTCNXT.AI delivered a three-phase transformation program:
Phase 1: RCM Performance Assessment
Conducted a comprehensive review of coding, billing, charge capture, accounts receivable, denial management, and reporting processes to identify operational bottlenecks and revenue leakage opportunities.
Phase 2: Revenue Cycle Strategy Workshop
Worked with leadership teams to quantify revenue opportunities, prioritize improvement initiatives, define future-state workflows, and establish a transformation roadmap.
Phase 3: Execution & Operational Transformation
Implemented workflow improvements, backlog reduction strategies, process standardization, KPI dashboards, denial management frameworks, and operational governance processes.
By combining RCM consulting, strategic planning, and execution support, BTCNXT.AI helped the hospital system establish a roadmap to improve revenue capture, enhance operational efficiency, and build a scalable foundation for long-term revenue cycle performance.
Revenue Recovery
Operational Efficiency
