Profit margins in healthcare face continued pressure – stagnate insurance reimbursement, a demographic shift due to an aging population, the list goes on. “There’s continued pressure on health system and provider reimbursement. They’re feeling the pressure from the payers. Insurance companies are consistently reducing what they pay for services. So it’s left to revenue cycle management (RCM) processes to make sure that as much revenue as possible is captured from each service and no revenue is lost,” explains Tyler Lewis, Founder and CEO of Sentrii RCM. To remain financially viable, healthcare providers, clinics, and hospitals must also understand the nuances of their revenue cycles. RCM is often viewed as a commodity and is not afforded the attention it should be.

In other words, healthcare providers need a standout revenue cycle management platform to close these gaps, and it’s the type of service that Sentrii does an exceptional job providing.

Sentrii offers their clients medical billing and revenue cycle management services. No matter the size of the operation, having Sentrii as a partner means that complications can be alleviated, making solutions scalable and customizable. “Every one of our clients is different. Their practices are different. Their technology is different. It never seems to be the same thing twice. We insert our process into how the client operates to make the revenue cycle a success. It starts with asking questions and ends with making a plan,” Lewis says.

Customized Solutions

The intuitive and digital solutions that Sentrii employs are based on each client’s individual revenue cycle needs. A seamless charge capture process is designed, starting with what may already be in place. From there, advancements are made. This way, all care is billed correctly and on time.

“With margins as tight as they are, healthcare professionals can’t have a revenue cycle partner losing services or delaying claims submission. If that happens, they’ll lose money. Technology alone isn’t the answer. There needs to be a team with expertise and experience deploying it. Sentrii focuses on the details and has a system that supports the technology, and I think that’s what differentiates us,” Lewis says.

Customizing solutions is only possible with RCM expertise and a deep understanding of client needs. “We strive to demystify processes with our clients. We make sure that we communicate and get on the same page by speaking in simple terms. Healthcare system administrators, physicians, and billing guys speak different languages. I continually push my team to communicate why we’re doing what we’re doing and what the results need to be. We ensure we connect with our clients whenever their busy schedules allow it,” Lewis says.

Clean Data

Revenue cycles are often monitored using KPIs built with bad data. “Garbage in, garbage out” Lewis says. An organization measuring “success” with bad information is doomed to fail, but, as Lewis also notes, “You can use system rules to defend against bad data, but rarely do you see billing companies doing that. The data we are given provides clues, but you must build a system to follow the clues. Health insurance companies use information to categorize subscribers, so why don’t more RCM companies use that information to create better data for their clients? We do. We want our clients to trust our information and be able to use RCM data to make informed decisions.” Lewis adds.

A Pioneer in Innovation

In more contextual terms, revenue cycle management is facilitated by a two-part process: observing the data and information of the current billing and claims processes and then creating actionable items for the organization to improve those processes. “We figure out what will make the biggest difference for the client using their data and deploy our team to fix those problems first. Each problem is addressed, and then steps are taken to eliminate the root causes. When we’re done we provide a summary. Healthcare claims data is a treasure trove of information, but if you don’t know how to organize and attack it, problems will persist. By deciphering precisely what’s going on, the Sentrii team can piece together solutions. It could be something as simple as identifying the use of an incorrect service code, educating the client, and implementing the change. Solutions can be more whole-scale, meaning an entire billing process is overhauled for something better suited to client needs. In this way, Sentrii acts like their physician clients do: diagnose and treat the problem.”

Frequently, Sentrii also uses data to ensure proper compliance. “We took a client through our discovery phase and realized there were services they were billing that weren’t compliant. We reviewed the regulations, outlined the necessary changes, and put a plan in place to fix the issue.” Lewis says.

Sentrii’s team is made up of dedicated people who specialize in what they do. Over the past 12 months, Sentrii has acquired three new businesses, each of which represents an incredible opportunity. “There is talent and good people behind those businesses with knowledge and expertise,” Lewis says. What matters is how Sentrii’s workforce helps clients by leveraging their collective years of experience in the healthcare industry—2024 promises to be a year of growth for Sentrii. “Everyone plays a role in the revenue cycle here. We keep our eyes open because you never know where a problem might surface, and we help our clients to do the same,” Lewis says.