Avben Healthcare Consulting

Hospitals & Health Systems

Revenue cycle control that holds across facilities

Hospital systems struggle when controls are inconsistent across facilities and leadership lacks a single operating view that drives closure. We install governance, workflows, and escalation pathways that stabilize cash without disrupting care delivery.

Request a Conversation Where revenue breaks KPIs
ControlsQueue disciplineEscalation pathwaysExecutive cadence
Facility viewSame KPI definitions across sites
Queue disciplineDecision rules + cadence
EscalationStructured payer pathways
Hospitals & Health Systems

Executive control over denials, underpayments, and AR

We install controls and a weekly cadence so performance is repeatable across teams, payers, and locations — without heroics.

Discreet resolution capability: When appropriate, we support respectful payer dispute resolution within established governance—kept professional and non-public.

Where cash breaks

Typical failure modes we map in the first 10–14 days.

Signals

  • Clean claim rate drifting by payer/service line
  • Denial overturn rate low or inconsistent
  • DNFB / coding backlog growing week-over-week
  • Contract variance unknown (paid vs contracted)
  • Appeals aging with no escalation ladder

Root causes

  • Missing controls (no owner, no cadence)
  • Work queues misaligned to payer rules
  • Documentation + coding handoffs inconsistent
  • Appeals built ad-hoc instead of industrialized

The operating model we install

A control system: dashboards → queues → escalation → weekly exec cadence.

Interventions

  • Denial prevention guardrails at intake + coding handoff
  • Industrialized appeals: templates, evidence standards, SLAs
  • Underpayment detection + recovery workflow by payer
  • Queue segmentation by payer, service line, and risk

What you get

  • Playbooks, templates, and manager scorecards
  • Queue design + SLA definitions per workstream
  • Payer performance reporting and variance tracking
  • Weekly leadership readout (10-slide style)

KPIs leadership can run

We choose a tight set of measures that drive behavior and closure.

Net collection rate
↑
measured weekly
Clean claim rate
↑
by payer
Denial overturn rate
↑
appeals yield
DNFB days
↓
coding throughput
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