August 19, 2020

Step 1: Install PB Revenue Guardian, Step 2: ???, Step 3: Profit!


Once again, the differences are diminishing between Hospital Billing and Professional Billing in the Epic universe. The latest piece of functionality to proliferate across the modules is none other than the Revenue Guardian!

Last year, Epic released the Professional Billing version of the Revenue Guardian. With all that has been going on in the past 6 months, many organizations put existing plans for implementation on hold. With the significant financial impact COVID leveled on healthcare organizations, there is no better time to make plans to implement a tool that can quickly increase your professional revenue. Below are the 3 key steps your organization can take to realize the benefits of this module today:

Step 1: Have your IT department review the Epic Galaxy article on the professional revenue guardian, paying special attention to the Epic released revenue guardian edits.

Step 2: Set up a series of meetings between the Revenue Integrity (RI) and PB IT team to determine direction and priority

  • Meeting 1: IT reviews functionality and introduces RI to the potential scope of the PB Rev Guardian
  • Meeting 2: RI identifies the top 5 impactful scenarios (based on work reduction or revenue gain)
  • Meeting 3: IT demonstrates how to review the edits via Epic reporting

Step 3: Revenue Integrity reviews all accounts hitting revenue guardian edits and decides on how to automate applicable charges and set up workflows to manually review non-automated scenarios.

Starting this process is easy and takes very little time or energy. Perfecting this process and operationalizing it is a different story. Understanding charging workflows in Epic, charging regulations, and the operational impact of pre-AR are all a must to receive the promised benefits of this module.

The Wilshire Group has seasoned consultants that have deep knowledge and experience around how to best plan and realize your best revenue cycle. If you want additional information on what the Revenue Guardian can do, what your organization should do about it, or how The Wilshire Group can be of assistance, do not hesitate to reach out to Tyre Pierce – or anyone else on our team. For more projects to improve your bottom line look through our Wilshire Wins on our website. Whether or not you are a current client, we have experts available to assist your team with any Revenue Cycle needs and questions you may have.


Senior Strategic Advisor

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