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Gretchen Case, MPH, Founding and Managing Partner, The Wilshire GroupThat’s where The Wilshire Group, a leading healthcare consulting firm, helps.
Wilshire checks all the boxes to become a trusted partner for providers, solving their challenges at the intersections of operations and technology to support their mission of offering exceptional care and attaining financial stability. Founding partners, Gretchen Case and Hank Smither, sought to create a professional home for a team of the best and brightest that bring an ideal blend of technical expertise and operational experience helping clients optimize electronic health record (EHR) investments and guide them to greater revenue recognition and workflow efficiencies.
“We embrace a comprehensive approach to revenue cycle management, serving as a one-stop solution that uses information technology and operational know-how to simplify complex workflows and produce real results you can count on,” says Ms. Case.
The Wilshire Group’s portfolio comprises all phases of the revenue cycle; patient access, revenue integrity, health information management, hospital and professional billing. Revenue integrity is a specialty in the middle revenue cycle where Gretchen and others at Wilshire are industry experts. RI is integral to revenue cycle, helping providers gain complete and compliant revenue recognition. The firm combines best practices with optimal use of technology to solve revenue integrity bottlenecks and improve workflows at the source. This helps providers reduce lost revenue, convoluted workflow, deficient reconciliation processes, and inconsistent pricing strategies.
Wilshire’s patient access services help healthcare providers develop a durable framework and pathways that improves the intake process, whether it’s robust decision trees, monitoring WQ’s or conducting eligibility verifications and managing their referral workflows. Wilshire Group’s team of seasoned experts aligns their clients with best practice standards, helping elevate their financial health and patients’ financial experience while reducing regulatory risks. This elevates operational efficiency, reliability, and scalability and reduces denials, billing edits, and referral leakage and enhancing payment collection rates and patient engagement scores.
Health information management is another area where The Wilshire Group shines. Its unrivaled system integration knowledge and operational experience allow the firm to lead organizations through the intricacies of health information management, coding, and clinical documentation improvement. Its revenue cycle operations are designed to provide comprehensive workflow solutions and interim leadership to clients for consolidating their IT and operations to enhance results. This enables hospital and professional billing optimization while streamlining processes and maximizing automation to help clients overcome the revenue flow challenges in billing.
Adding to these well-knit services of The Wilshire Group is its advisory and mentorship support, wherein seasoned professionals or revenue cycle leaders step in as interim leaders or mentors to address clients’ needs. These leaders provide ample support and guidance to reduce risks during government audits and stabilize clients’ departments during staff transitions.
We embrace a comprehensive approach to revenue cycle management, serving as a one-stop solution that uses information technology and operational know-how to simplify complex workflows and produce real results you can count on
Client engagement is central to The Wilshire Group’s service excellence. Its team always pushes the boundaries to gain a holistic understanding of their needs and deliver a solution that best fits client’s requirements. A recent success involved a healthcare organization going through a revenue cycle management initiative. The Wilshire Group conducted application integrations, system analysis, and resource review to find areas that required improvements. After thorough evaluations, Wilshire highlighted areas of opportunities and recommended improvements, leading the revenue cycle management endeavor to success.
Such successes testify to The Wilshire Group’s hands-on approach to integrating its operational experience with IT and systems knowledge that allowed it to cultivate a renowned reputation for delivering impactful solutions. Today, The Wilshire Group has begun expanding their strategic partnerships by partnering with other innovators in the healthcare revenue cycle space to drive operations and technology into the future. Wilshire has partnered with Claim Capital, a software development company that leverages machine learning to proactively identify denials and trends. Gretchen has also been developing some RI tools that can improve the integration of charges into clinical modules, and another that is able to use claim data to find lost revenue across professional and hospital claims.
Company
The Wilshire Group
Management
Gretchen Case, MPH, Founding and Managing Partner, The Wilshire Group
Description
The Wilshire Group is a healthcare consulting firm with years of experience and success in implementing information technology and organizational transformation. Specializing in revenue cycle management and Epic functionality, we leverage technology to streamline intricate workflows, enhance operational efficiency, and optimize core business assets.
The Wilshire Group News
The Wilshire Group Expands Breadth and Depth of Revenue Cycle Services with Acquisition of Trifecta Group
“We are pleased to announce the acquisition of Trifecta Group and we look forward to the significant value this transaction will create for our clients,” said Hank Smither, co-Founder and Managing Partner of The Wilshire Group. “The Trifecta Group strengthens our position in revenue cycle management and broadens our subject matter expertise. Their expertise and reputation for results complement our mission to deliver exceptional value to our clients. Together, we will continue to set the standard for revenue cycle management and consulting in the healthcare industry.”
The revenue cycle unifies the business, administrative and clinical functions in healthcare. When friction between these revenue cycle management functions is reduced, healthcare organizations can improve the patient experience, maximize claim reimbursement, and increase patient service revenue. The Wilshire Group brings a comprehensive approach across the revenue cycle, beginning at the front end with patient access through coding, billing, and reimbursement at the back end. From electronic health record (EHR) implementations to large-scale process improvements, The Wilshire Group has decades of healthcare, revenue cycle operations, and informational technology experience to improve healthcare organizations’ revenue recognition and optimize workflows.
“Joining forces with The Wilshire Group is an exciting opportunity for our team and clients,” added Candace Caballero, CEO of The Trifecta Group. “Our combined strengths will support and benefit our clients with expanded resources and an enhanced patient experience. Our vision, mission and culture are well aligned which was very important to us and positions us all for success.” Candace will remain engaged at The Wilshire Group as a client facing executive advisor and help manage the integration of the teams.
The Trifecta Group serves payers, providers, and healthcare systems across the country. Its portfolio of services include evaluation and assessment of people, process and/or technology performance, project management, re-organizations, and assistance with mergers, acquisitions or system implementations. The combined Wilshire Group and Trifecta Group team is committed to maintaining the highest standards of service and delivering measurable revenue cycle results for healthcare organizations.