Dave Purcell
Chief Financial Officer
Payors Providors and Managed Care Consultants

Dave’s philosophy on Revenue Cycle is that small niche firms have it all over the large one stop shopping firms. Dave cut his teeth working for Ernst and Young,
back when they were Ernst and Whinney and there is no better training ground for hospital consulting then Ernst. In addition to Dave’s Big 5 experience,
his subsequent 27 years have included 7 years as Controller, and 15 as CFO of four different large facilities such as OSU Medical Center and others. This wealth
of experience has taught Dave that niche firms were his best value for rapid cash flow improvements. In addition, Dave was fortunate to have been a charter
member in the CFO Roundtable in 1994 and that group’s express purpose was to spend four days a year problem solving with peers. All participants were
encouraged to bring both their questions and solutions to the meetings and Dave learned a tremendous amount from his peers on how to solve virtually any revenue
cycle issue that occurs in health care systems.

Since 2001, Dave has been a Revenue Cycle consultant who represents the services of the best of breed range of different firms that provide solutions for one
or more of the common revenue cycle challenges facing hospitals today. As a CFO, Dave always shopped for the BEST solution in the market, which included
the concept of the biggest bang for his investment as well as how quickly the solution could be implemented. One of Dave’s pet peeves as a CFO was that he saw
most hospitals wasting huge amounts of time shopping for one best vendor. Should you decide to use our Revenue Cycle services, Dave will bring over 30 years
of experience with him plus the BEST solutions in the healthcare market.

Dave’s approach to Revenue Cycle Consulting is very simple and straightforward. We collect advance information two weeks before the fieldwork visit to
prepare for interviews. Dave personally conducts four days of fieldwork, where all key managers in the Revenue Cycle process are interviewed. We document
financial and operational issues and compare you hospital with best practice hospitals in the industry. We then issue a report of findings approximately two weeks later.
Dave has conducted many of these engagements for our clients and the findings have ranged from a low of 3% increase to 8% increase in Income from Operations.
All of the findings will show the cash flow impacts as well as the cost of implementation and ongoing costs. The single factor most often overlooked is the opportunity
cost of delayed implementation. If a project can provide $2 million in annual income statement benefit then a one-year delay costs the organization $2 million.
Our job is to help the hospital decide what they want to do and then implement the solutions in a timely fashion. We will also advise as to the order of implementations
to provide the biggest bang or benefit quickly to your organization. All of our vendors are considered “plug and play” which means the bulk of the work is done by
the external firm and not by the hospital staff. All of our firms are very interested in knowledge transfer, even to the extent of job elimination. Should your internal
team become comfortable with getting the same results as the external firm our job is completed.

We are currently serving over 40 hospitals with one or more of our revenue cycle products and references are available upon request.

A description of some of the services we offer is shown below and we have provided a brief overview of how each service benefits the client.

• Medicaid Eligibility Services:
• Full Service Collections Services:
• Self-pay and EOV collection services for the entire continuum.
• A previous client hospital self-pay collection went up from 12% to 34% utilizing this service.
• Another client hospitals utilizing EOV services increased their collections $800,000 per month with minimal patient complaints
• Insurance Follow Up Services: This service acts as an extension of the business office for all sized accounts the business office is not
  staffed for timely follow up efforts. A quick review of the aged trial balance indicates the opportunity for improvement. This service
  has produced an annual benefit at a client hospital, which exceeds $16 million in income statement benefit at a cost of $1.2 million.
• Medicare Inpatient Underpayments: This service does part A audits, which typically find an additional 2% of Part A reimbursements on a contingency basis.
  In addition, an excellent managed care software is offered that tests for underpayments for all government and commercial payers and this service
  can also be implemented on a contingency basis.
• Medicare Inpatient Documentation: This service helps hospitals optimize their Medicare CMI while being compliant with the Medicare guidelines.
  This service can often help the hospital increase their CMI anywhere from 6 to 12 points.
• Registration Process Improvement: The product we represent is a software tool that significantly enhances the accuracy of the insurance registration process.

Is your hospital revenue cycle performing at this level?
If not, we can help you get there!


Financial/Revenue Cycle Metric Top Quartile
1 Net Revenues per Case Mix Adjusted Admission Using All Payor CMI >$7,000
2 Net Days in A/R 50 Days
3 Bad Debts as % of Gross Revenue < 3%
4 Self Pay Receipts as % of Self Pay Revenues > 25%
5 Average Self Pay Collection per Account Collected > $350
6 DNFB Days beyond Hold Period < 2 Days
7 % A/R over 90 days old < 15%
8 % A/R over one year old < 3%
9 Annual Underpayments Captured as % of Net Revenues > 3%
10 Medicare CMI as Function of Surgical Case % 1.0 Plus Surgical % x 2