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Operational Solutions Validated Through Pilots
Operational Solutions Validated Through Pilots
Jones Healthcare Solutions applies its validated consulting methodology to many healthcare operational constraints that directly impact revenue, reimbursement, and capacity. We do not deploy broad solutions. We test specific changes and expand only what proves value. Examples of specific solutions are below.
1. Provider Time-to-Revenue Optimization
1. Provider Time-to-Revenue Optimization
The Constraint:
Delays in onboarding, credentialing, and payer activation prevent new providers from becoming billable, slowing revenue realization and increasing administrative drag as more providers are added
What we test:
Workflow sequencing for onboarding and credentialing
Standardization of documentation and submissions
Elimination of rework and stalled approvals
Coordination of payer, licensing, and access readiness
KPIs We Measure
Days from provider start date to first accepted claim
Percentage of providers billable within defined time thresholds
Administrative hours per provider onboarding cycle
Typical Outcomes
Faster provider activation
Reduced onboarding effort and rework
Earlier and more predictable revenue realization
2. Revenue Protection & Reimbursement Reliability
2. Revenue Protection & Reimbursement Reliability
The Constraint:
Claims denials, stalled reimbursements, and prior authorization failures create revenue leakage and unpredictable cash flow.
What we test:
Claim submission quality and denial resolution workflows
Prior authorization sequencing and approval processes
Targeted rework reduction for high-denial categories
KPIs We Measure:
KPIs We Measure:
Percentage of claims paid without rework
Dollar value of claims outstanding beyond 30 days
Average days from claim submission to payment
Typical Outcomes:
Typical Outcomes:
Reduced reimbursement delays
Improved payment reliability
Lower administrative burden associated with rework
3. MA and Support Capacity Optimization
3. MA and Support Capacity Optimization
The Constraint:
Support staff capacity is often misaligned with patient demand, leaving paid hours underutilized during low-volume periods while peak times remain constrained.
What we test:
Alignment of MA staffing to rooming demands
Realignment of excess capacity into defined secondary workflows
Conversion of idle time into related supporting activities
KPIs We Measure:
MA rooming utilization rate
Percentage of paid support hours producing defined outcomes
Idle hours reduced per week
Typical Outcomes:
Improved utilization of existing staff
Increased operational output without additional headcount
Better alignment between staffing and patient flow
4. Operational Throughput & Flow Improvement
4. Operational Throughput & Flow Improvement
The Constraint:
Bottlenecks in intake, call-center tasks, documentation, or handoffs reduce patient throughput and create downstream delays.
What we test:
Intake-to-rooming workflows
Task sequencing between clinical and support staff
Elimination of redundant or low-value steps
Check-in and Check-out efficiency
KPIs We Measure:
Patients served per support hour
Average wait time per visit
Cycle time from check-in to provider-ready
Typical Outcomes:
Increased patient throughput
Reduced wait times
Smoother clinic flow without schedule disruption
5. Compliance & Activation Continuity
5. Compliance & Activation Continuity
The Constraint:
Licensing lapses, credentialing gaps, and monitoring failures expose clinics to downtime, compliance risk, and lost revenue.
What We Test:
Centralized tracking of licenses and renewals
Credentialing and monitoring workflows
Submission timing and follow-up processes
KPIs We Measure:
Renewals submitted on time
Provider downtime avoided
Average time to resolve compliance alerts
Typical Outcomes:
Reduced compliance risk
Continuity of provider billing eligibility
Improved administrative reliability
Each solution is delivered through a focused pilot, measured appropriately, and proves impact before solutions are scaled
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