What We Do
- Enterprise Revenue Alignment
- Operational Performance Control
Structured Revenue Operations for Hospitals & Health Systems
Hospitals and integrated health systems operate across multiple service lines, facilities, and payer contracts — where process variation and workflow misalignment can significantly impact financial performance. Operational leaders require visibility, standardization, and accountability across the entire revenue cycle.
Our approach focuses on aligning front-end access, clinical documentation, coding, billing, denial management, and accounts receivable functions into a coordinated revenue framework. We implement system-wide controls that reduce throughput gaps, strengthen reimbursement consistency, and improve operational efficiency across departments.
Through disciplined oversight, performance monitoring, and structured RCA-driven improvements, we help hospitals and health systems stabilize cash flow while supporting sustainable operational performance at scale.
Revenue Cycle Management Process
We follow a structured, enterprise-wide revenue cycle framework designed for hospitals and integrated health systems operating across multiple facilities and service lines. From patient access through final reimbursement, each phase is aligned to operational controls, compliance standards, and system-level performance goals.
Our approach emphasizes standardization across departments — ensuring eligibility, documentation, coding, billing, and follow-up functions operate within coordinated workflows. By reducing process variation and improving cross-functional accountability, we help health systems strengthen reimbursement consistency and operational efficiency.
Through centralized oversight and performance governance, we enable leadership teams to reduce revenue leakage, accelerate cash flow, and maintain financial stability at scale.
Access & Front-End Standardization
System-wide insurance verification, authorization governance, and patient access alignment to reduce downstream claim disruptions across facilities.
Clinical Documentation & Coding Integrity
Cross-functional coordination between clinical, coding, and billing teams to strengthen accuracy, compliance, and reimbursement consistency.
Enterprise Denial Intelligence
System-level denial trend analysis and revenue leakage identification supported by structured Root Cause Analysis (RCA) and targeted Corrective & Preventive Action (CAPA) frameworks.
Accounts Receivable Optimization
Centralized A/R oversight, payer escalation protocols, and aging control to improve cash acceleration and reduce outstanding receivables.
Integrated Revenue Operations
Cross-Functional Accountability Frameworks
Enterprise Risk Mitigation
Cash Flow Acceleration
Data-Driven Performance Visibility
System-Level Financial Control
What revenue cycle metrics should hospital CFOs be tracking most closely?
The five most important: net collection rate (target 95–98%), days in AR (target under 40–45), first-pass denial rate (target under 5%), cost to collect (target under 3% of net revenue), and AR over 90 days as a percentage of total outstanding AR. These five, tracked by payer and service line, surface the majority of revenue cycle problems.
How does Squadyen handle the complexity of multi-payer environments in health systems?
Our workflows are built around payer-specific rules and timelines — tracking denial patterns, payment variance, and AR aging at the payer level, not just in aggregate. This granularity is what allows us to identify which payers are systematically underpaying or delaying and drive targeted corrective action.
What is underpayment recovery and how much revenue is typically at stake for hospitals?
Underpayment recovery identifies claims where payers paid less than the contracted rate — without issuing a denial. Industry estimates suggest hospitals lose 1–3% of net revenue to undetected underpayments annually. For a $200M health system, that represents $2–6 million in revenue already earned but not fully collected.