Empowering Health Systems with strategies that will Maximize reimbursements and Optimize payer contracts
Take control of your revenue cycle with consultation tailored to your unique practice goals
Expert advisors
Impactful Solutions
Transform your organization with our expert consulting services that promote financial growth and streamline innovation. Drive Revenue Growth Through Our Strategic Consultation. Contact us today to start your journey towards success.
Our process applies techniques from a variety of disciplines, distinction in detail and gives careful attention to Secure Better Payer Contracts with our Proven Managed Care Expert Advisors who have background experience with all major Health Systems.
Whether your an IPA, MSO, PHO, or ACO our process applies techniques from a variety of DMAIC Operational solutions and strategy to succeed as we partner in Navigating Care Challenges within CMS regulatory compliance and focus .
We prioritize working alongside with you and payer’s to streamline processes by ensuring efficient delivery of services to your patients. Our team will help you understand and work with your population health to effectively align your business operation model.
RCM Implementation Results
Taking Complete Control of the
Revenue Cycle
Comprehensive Payer Alignment Strategy · Cost Efficiencies · Revenue Integrity · Compliance
12-Month Net Revenue Gain
Achieved through our focused payer contract realignment, revenue leakage recovery, and full-cycle RCM optimization across a $289.7M payer mix.
Revenue Leakage Recovery
$49.0M returned to net revenue by closing preventable leakage
Across six leakage categories — denials, underpayments, coding gaps, eligibility failures, charge capture, and contractual variances — annual leakage fell from $66.7M to $17.7M over the engagement, a 73% reduction driven by the workstreams detailed below.
Payer Mix & Contract Intelligence
Denial Rate by Payer — Engagement Impact
| Payer | Prior Rate | Current | Reduction |
|---|---|---|---|
| Medicare FFS | 5.3% | 2.8% | ↓ 47% |
| Medicare Advantage | 9.2% | 4.1% | ↓ 55% |
| Commercial PPO | 8.7% | 3.9% | ↓ 55% |
| Medicaid MCO | 13.4% | 6.2% | ↓ 54% |
| Commercial HMO | 7.8% | 3.5% | ↓ 55% |
12-Month Operational Outcomes
12-Month Performance Trajectory
Days in A/R and claim denial rate, engagement start to current
Monthly Cash Collections Velocity
Steady month-over-month growth driven by denial reduction, faster authorization turnaround, and front-end eligibility improvements.
Net Cash Collections — January through December 2025
Monthly net collections in $M · 12-month engagement window
Revenue Leakage Analysis — Annual
Leakage by Category — Before vs. After
Annual leakage, in millions of dollars
A/R Aging Distribution
Dramatic migration toward current receivables — the 120+ day bucket contracted from 5% to 2%, eliminating substantial write-off exposure.
A/R Aging Buckets — % of Total A/R
Engagement start vs. current state
Denial Rate Performance by Payer
Payer-specific denial reduction achieved through targeted appeal workflows, authorization redesign, and contract compliance monitoring.
Claim Denial Rate by Payer — Before vs. After
Percentage of submitted claims denied, by payer type
Regulatory & Compliance Performance
Engagement Return on Investment
Is your organization leaving
revenue on the table?
Our professional advisors bring 20+ years of payer-side and provider-side experience to your RCM, contract alignment, and compliance challenges.
Schedule a Free Strategy CallNo obligation · U.S Based & National reach
How We Work
Work Process
01
Performance Optimization
We help organizations understand where Quality, Compliance,Contractual as well as Financial Risk lives and how to turn it into sustainable performance.
02
Planning & Enablement
We will work with you to create a personalized plan to help you achieve your goals by focusing on alignment and highlight real results.
03
Operational Efficiency
We streamline payer partnership operations so care teams act faster, costs decrease, and outcomes improve.
Success
Proven track of successfully operationalizing groups for over 20 years
12k
Clients
20+
Years
Who are we
Our highly professional team help organizations improve financial performance, quality outcomes and operational efficiency.
✓ SIX SIGMA BLACK BELTS
✓ Always Available
Testimonials
Our Customers Said
★ ★ ★ ★ ★
4.85 from 1,300+ reviews
Excellent
Really impressed by the quality of service and commitment shown by the OPS team at CMS1.
★★★★★
George Bennett
Highly Recommended
They took care of all the guidance and MA meetings for our business, allowing us to focus on growth and success.
★★★★★
Lila Epstein
Outstanding client feedback
Our company was able to achieve an unprecedented number score gains in many of our new markets thanks to this team.
★★★★★
David O’Brien
