Private Revenue and Funding Maximisation

O’Connell has a deep understanding of the alternative funding and revenue models applicable for various services provided by hospitals.  Using this understanding and our data analytics capability, O’Connell can assist hospitals to identify opportunities to generate additional revenue and funding from the services they are providing.

Examples of potential opportunities O’Connell has previously identified for clients to increase their revenue and funding include:

  • Under billing of services (eg medical imaging services):
    • Not all private service are being billed
    • Not all applicable CMBS items are being billed, where multiple CMBS items are billable
    • Services are being billed using a CMBS with a lower value than the highest value appropriate CMBS item(s)
    • Opportunities to changes processes to enable the hospital to maximise the potential billable revenue (eg when the hospital has a licenced and unlicensed MRI)
  • Analysis of the ABF funding compared to potential CMBS revenue to identify revenue optimisation opportunities
  • Analysis of the ABF funding for specialised and complex services (eg peritonectomy surgery)
  • The use of privatised service models (eg cardiac catheter labs) to generate additional revenue for the doctors and hospital.