Helix Advisory

💰 PB Zero Balance ≠ Zero Opportunity 💰 If you’re only auditing hospital/facility accounts, it may be time to shine a light on the professional side. We are helping health systems and medical groups uncover real revenue from closed PB claims no matter the EHR or billing platform. Silent denials, coding discrepancies, modifier misapplications, and payer logic errors all contribute to revenue leakages on accounts marked as $0. Using a contract-based, data-driven approach, we: 1.     Reconstruct claims using 837/835 data 2.     Identify underpayments & appealable variances 3.     Deliver recoveries with minimal provider disruption 4.     Provide full reporting + root cause analysis 💰 💲 Clients recover 3–6% on zero balance PB claims — dollars previously thought unrecoverable. 💲 💰

Special day for all of us at Helix Advisory to see our CEO Zack Higbie featured on a vital topic to our industry and the future of revenue cycle!

Happy Patient Access Week! This week, we recognize and celebrate the incredible professionals on the front lines of healthcare access — the teams who ensure patients receive timely, clear, and compassionate support navigating their care journey. From scheduling and insurance verification to financial counseling and beyond, patient access teams are the heartbeat of the patient experience. Their work is often behind the scenes but always essential. At Helix Advisory, we are proud to partner with organizations who value accuracy, transparency, and efficiency in every step of the revenue cycle. We see firsthand how strong patient access sets the tone for everything that follows — and we’re committed to helping our clients optimize these critical processes so they can better serve their communities. To all the access professionals making a difference every day: THANK YOU! Your dedication empowers patients and strengthens the entire healthcare system. #PatientAccessWeek #HealthcareHeroes #RevenueCycle #PatientExperience #HelixAdvisory #AccessMatters #HelixHeroes

It wasn’t the result we wanted, but a great Opening Day for the Helix Advisory team. Thank you to our friends at Medasource for inviting us. ⚾️ 🌭

If this feels like your typical day… we are here for you! 🤦♂️🫣😂 Between payer denials, underpayments, and never ending appeal loops - Helix Advisory will help you clear those hurdles! 🥇 🏃♀️ 🤸♂️

Every closure isn’t just a headline - it’s the loss of access for patients, jobs for caregivers, and a warning sign for the rest of the system. And for those of us who work inside healthcare, the reasons aren’t a mystery. Margins are razor thin. Denials are climbing. Payers are getting smarter, faster, and more aggressive and health systems are struggling to keep up. Revenue cycle teams are being asked to do more with less, often without the tools or support they need. This is why we started Helix Advisory. We came from inside the system. Leading revenue cycle teams, building technology, and fixing broken processes. We saw how hard people were working just to keep the lights on. We also saw how often vendors made things worse: layering on complexity, overpromising automation, or delivering “solutions” that didn’t fit the problem. We built our team around the belief that doing the work well can be the difference between a hospital staying open or closing its doors. Our job is to quietly make the system stronger, so frontline staff can focus on patients not prior auths, denials, or audits. This moment in healthcare is hard. But we believe in doing the work, in earning trust, and that it’s still possible to fix what’s broken one hospital at a time.

🍀 Happy St. Patrick’s Day from Helix Advisory! 🍀 Top o’ the mornin’ to all our healthcare friends! This St. Patrick’s Day, our cheerful Helix Advisory Leprechaun is dancing through the fields of opportunity, gleefully gathering lost treasures of revenue for hospitals everywhere. But, with a sprinkle of magic from our automation and AI, we’re on the hunt 24/7/365, uncovering hidden gold nuggets tucked away in zero balance accounts!  🍀 Picture a rainbow 🌈 of possibilities as our technology works tirelessly, ensuring every hospital’s financial pot of gold shines brighter. It’s a festive reminder of the joy in reclaiming what’s rightfully yours—all year round!   Wishing you a day filled with green cheer and lucky moments!

Raising over $16K for Soul Survivors Ink is an incredible achievement and we applaud the commitment to supporting this vital cause. Community-driven initiatives like this truly make a difference, and we’re honored to be part of an industry that values empowerment, advocacy, and giving back. A huge thank you to HFMA Arizona Chapter, Gidget Bowers CRCR, event partners, and attendees for making this possible! We look forward to seeing the continued impact of this incredible mission and supporting this great cause.

The recent report indicating that 748 hospitals across the United States are at risk of closure is a stark reminder of the challenges facing our healthcare system. These institutions are not just medical facilities; they are vital lifelines that provide essential care, employment, and stability to their communities. We deeply understand the gravity of this situation. Our mission is to support these critical community pillars by enhancing their financial stability and operational efficiency. By addressing the root causes of financial distress—such as reimbursement challenges, operational inefficiencies, and evolving regulatory demands—we aim to prevent closures and ensure that hospitals continue to serve their communities effectively. Our commitment is unwavering. We stand ready to collaborate with healthcare providers of all sizes, offering tailored solutions that not only address immediate financial concerns but also pave the way for sustainable growth and resilience. Together, we can navigate these challenges, safeguard essential healthcare services, and strengthen the fabric of our communities. https://lnkd.in/gGa4u66k

Navigating 2025’s Revenue Cycle Headwinds with Precision and Strategy: Gidget Bowers, CRCR The evolving complexity of revenue cycle management continues to challenge healthcare organizations in 2025. The latest Kodiak benchmarking report highlights three dominant headwinds that are increasing financial risk for providers: Escalating Denial Rates – Initial and final denial rates have been steadily increasing for 5 consecutive years, with prior authorization, medical necessity, and RFI denials driving the trend. Without proactive intervention, providers will continue to see growing revenue leakage and A/R deterioration. Payer Strategy Shifts – Medicare Advantage & Commercial Plan Behavior – MA and commercial payers are leveraging pre-payment audits, inflated RFI denials, and aggressive post-payment review tactics. These trends indicate a systematic approach to slowing payments and reducing reimbursement, requiring sophisticated revenue integrity measures to counteract financial erosion. Patient Responsibility & Collection Challenges – Commercially insured patients are now responsible for a larger share of their medical costs, yet collection rates after insurance have declined by 3.1% year-over-year. This signals a growing liquidity risk, especially as federal changes to credit reporting reduce the incentives for patient payment compliance. Helix Advisory Approach to Revenue Resilience We recognize that conventional RCM methodologies are insufficient in today’s environment. Payers have optimized their revenue strategies—providers must do the same. Our approach integrates advanced analytics, automation, and payer-specific intelligence to counteract financial pressures and drive sustainable revenue cycle performance. Denial Prevention & Recovery Optimization Deploy AI-driven automation to detect and resolve pre-submission claim issues, reducing preventable denials Leverage payer-specific data modeling to anticipate high-risk claims and proactively address documentation deficiencies Use generative AI for appeal generation, optimizing denial overturn rates and reducing administrative burden Payer Accountability & Revenue Integrity Implement real-time payer scorecards to track adjudication trends and escalate patterns of inappropriate denials Apply contract compliance analytics to identify underpayments, misapplied fee schedules, and reimbursement discrepancies Pursue targeted ZBR's—as evidenced by a recent $4M recovery that moved a provider from negative margin to financial stability. A Data-Driven Future for RCM Hospitals and health systems can no longer afford reactive revenue cycle strategies. The future of RCM demands proactive intervention, payer intelligence, and advanced technology integration to ensure financial viability. At Helix, our expert-driven and technology-enabled approach ensures that providers don’t just mitigate revenue cycle risks—they optimize financial performance and reclaim control of their reimbursement strategies.