Driving Revenue and Financial Transformation with SIS RCS

Saint Luke's South Surgery Center, located in Overland Park, Kansas, performs 300-400 cases per month with major service lines in cataracts, GI, orthopedics, and self-pay procedures. While clinical operations were strong, the ASC faced a range of revenue cycle management (RCM) challenges, leading to financial instability and limited performance transparency.

The center used an outdated practice management software with multiple manual, paper-based processes, compounding difficulties caused by business office turnover and a backlog of unresolved billing. NueHealth, the center’s management company, identified an urgent need for experienced revenue cycle support to restore financial health and implement consistent operational processes across billing, coding, A/R management, and payment posting.

Saint Luke's South initially engaged SIS Revenue Cycle Services (RCS) on a short-term basis to address turnover challenges. The SIS RCS team quickly identified several significant revenue cycle issues:

• Hundreds of unbilled or temporarily coded cases pending finalization
• Unposted or incorrectly posted payments, resulting in inaccurate balances
• Unresolved clearinghouse rejections and denials
• Outdated insurance setups and absent authorizations
• Use of incorrect CPT codes, modifiers, and incomplete documentation
• Absence of standardized, documented workflows for billing, follow-up, payment posting, and A/R oversight
  
  

1. Comprehensive Billing and A/R Remediation

• Conducted a thorough audit of all unbilled inventory to identify and categorize outstanding charges.
• Reviewed, corrected, and submitted high volumes of claims that were temporarily coded or reversed, ensuring accuracy and compliance with established guidelines for timely processing.
• Addressed and resubmitted all historical clearinghouse rejections to resolve past submission errors and ensure successful claim processing.
• Resolved payer configuration issues and corrected missing or inaccurate coding.

2. Assignment of Experienced RCM Specialists

SIS assembled a dedicated team with expertise aligned to the complexity of Saint Luke's RCM environment:

• 1 charge entry & billing specialist
• 1 payment posting specialist
• 2 A/R specialists
• A dedicated team of CPC-certified coders under a separate coding contract

3. Overhaul of Payment Posting and Reconciliation

Upon taking over payment posting responsibilities, SIS thoroughly identified and resolved critical issues, including:

• Unposted payments and overlooked balances caused by previous posting errors, which had resulted in inaccurate financial records.
• Missing contractual adjustments resulting in artificially inflated accounts receivable (A/R) figures, creating inconsistencies in financial tracking.

SIS took proactive steps to address these historical discrepancies, ensuring all prior errors were rectified. Additionally, they implemented a structured, reliable monthly reconciliation process to maintain accuracy and prevent similar issues from recurring. This approach not only improved financial clarity but also established a foundation for smoother operations moving forward.

4. Standardization of Revenue Cycle Workflows and Reporting

To drive consistency and efficiency, SIS implemented clear, repeatable workflows and reporting standards across several key financial areas:

• Daily charge reconciliation: Ensuring all charges were accurately captured and reconciled on a daily basis to prevent revenue leakage.
• Timely dictation follow-up: Establishing a systematic process to promptly address and resolve any delays in physician dictation, which could otherwise delay the billing cycle.
• Denial management and appeals operations: Creating a structured approach for managing claim denials and executing appeals to recover otherwise lost revenue.
• Prioritization of aged A/R: Implementing a strategy to systematically address and prioritize older, outstanding accounts receivable to improve collection rates.
• Delivery of monthly financial overviews: Committing to the regular delivery of detailed financial reports, including key metrics like cash collections, net revenue, A/R buckets, and payer mix, to provide a consistent, high-level view of performance.

This commitment to comprehensive reporting provided NueHealth with actionable visibility, allowing them to track ongoing improvements and monitor progress with greater precision.

Saint Luke's South Surgery Center realized measurable, rapid improvements in its revenue cycle performance:

Enhanced A/R Aging

As the SIS RCS team worked through unbilled volume, overall aging improved significantly.

• A/R > 60 days: improved from 50% to 37%
• A/R > 120 days: improved from 35% to 24%

Cash Collections Recovered and Exceeded Benchmarks

As SIS implemented its new revenue cycle management processes, they systematically addressed the backlog of unresolved accounts receivable (A/R) and began the meticulous work of correcting and resubmitting previously unpaid claims:

• The initial $800,000 cash shortfall was reduced by over 68%
• Fully achieved first month cash target of $1.8 million
• Regularly exceeded cash targets for subsequent months

Optimized Billing Accuracy

With enhancements in payer setup, greater coding precision, and improved consistency across the entire workflow, Saint Luke's achieved several key billing improvements. These refinements led to:

• Increased claims accuracy and clean claim rates
• Higher first-pass reimbursement rates
• Improved denial prevention and management

Strengthened Operational Stability

By fostering a culture of consistency and accountability at Saint Luke's South, SIS helped fortify their revenue cycle from end to end. This was achieved via:

• Timely, reliable billing processes
• Accurate posting and reconciliation
• Structured follow-up and effective appeals processes
• Clear and actionable visibility into ASC performance

NueHealth consistently cited the SIS team’s professionalism, responsiveness, and commitment to operational excellence, noting the team “goes above and beyond” to deliver results.

What began as a short-term staffing arrangement has evolved into a trusted, long-term strategic partnership, anchored by transparency, measurable financial achievement, and operational discipline. With SIS RCS, Saint Luke's operates with greater predictability, improved cash flow, and enhanced process integrity.

Encouraged by these outcomes, NueHealth is expanding its partnership with SIS across additional centers—with more to follow.

SIS is proud to empower hundreds of ASCs in building a sustainable, scalable revenue cycle platform—delivering financial stability today and positioning the organization for growth tomorrow.

Ready to streamline your facility's operations and maximize profitability?

Learn more about SIS Revenue Cycle Services by scheduling a consultation today.