Revenue cycle solutions

Clinically integrated revenue cycle

PwC can leverage its vast array of accelerators, services and alliances and develop a custom approach to assist clients in developing clinically driven RCM capabilities. Explore PwC’s range of offerings which connect clinical and revenue cycle platforms to drive value.

Drivers for Sustainable Revenue Cycle Performance Improvement

Access to care

PwC can help remove barriers to care through digital enablement/automation, transforming the patient experience for our clients. We work with providers to identify multiple access channels for patients to make finding the right care and monitoring their health easy.

Workforce of the future & virtual interactions 

As healthcare becomes increasingly digitized, providers must invest in their digital infrastructure to keep up with competitive market demands and virtual working arrangements. PwC partners with clients to enable a more productive workforce through automation, virtual working arrangements and the development of virtual provider-patient interfaces.

Leveraging technology

PwC champions provider transformation through operationally led and technologically enabled initiatives. PwC helps both traditional and non-traditional healthcare providers assess and manage their technology vendor relationships while offering robust support models from design to implementation.

Patient financial journey & price transparency

Amidst the competitive healthcare landscape and changing regulatory requirements, price transparency is a critical factor driving patients' choices within the healthcare market. PwC helps providers incorporate technology solutions that enable patients to review insurance and self-pay prices for services rendered, increasing transparency and instilling trust.

Revenue cycle performance & cost containment 

As scale and innovation push revenue cycles to greater levels of efficiency and output, the search for incremental value must be guided by an organization's goals and driven by quantitative measurement. PwC can help organizations manage costs strategically while also working to fuel long-term growth.

Additional PwC support services

In addition to core revenue cycle services, PwC’s revenue cycle management practice collaborates with other business segments across platforms to facilitate broad-scale transformation for healthcare provider organizations. Survey PwC’s support services to determine which solution meets the needs of your healthcare organization.

In partnership with our Enterprise Strategy and Value practice, PwC’s revenue cycle management team helps providers experiencing sustained financial stagnation by assessing key revenue cycle benchmarks and identifying investment opportunities for broader cost containment and growth.

Through joint Cloud & Digital engagements, PwC’s revenue cycle management team enables digital transformation for complex healthcare organizations. PwC helps drive strategic alignment within healthcare organizations for a digital future and identifies opportunities for digital value creation through analytics and automation within the revenue cycle.

For providers considering mergers, acquisitions and/or financial restructuring, PwC’s Deals practice, in partnership with revenue cycle management, can help guide providers through complex financial decision-making.

As providers may struggle to keep up with changing regulatory environments, PwC’s Health Industries Risk and Regulatory practice can help ensure the proper identification and application of quality and regulatory control points within new and existing revenue cycle processes and technology.

Leveraging our Fit for Growth (FFG) Model, PwC's Revenue Cycle team can support healthcare organizations to re-assess strategic priorities across the value chain to cut costs and grow stronger at the same time. Through FFG assessments, PwC helps healthcare organizations identify differentiating capabilities needed to thrive in competitive operating environments to pave the way for sustainable, long-term growth.

Revenue Cycle Consortium

What is the Revenue Cycle Consortium?

PwC has orchestrated a unique opportunity for participating prestigious health systems to join forces and share leading practices for mutual benefit as well as share concerns impacting their health system(s). 

If you’re interested in learning more about the Revenue Cycle Consortium, please contact us for more details about becoming a member.

“The PwC Consortium is a valuable forum to gather best practices and exchange key strategies to address today’s revenue cycle challenges. Many of the members have become friends and look forward to the annual meeting to share ideas and innovative strategies during the informal round-table format. The forum is unique in that, not only are outcomes shared, but “how the results were obtained” are shared. Revenue cycle leaders from across the country gather as a collaborative consortium to solve revenue cycle challenges and identify best practices – designing their own consortium agenda.”

— Revenue Cycle Consortium Member

Products and services


SMART is PwC’s industry-leading coding quality monitoring system that provides healthcare organizations with targeted, customizable insights to suit organizations’ needs. SMART can lead to a potential ROI of 10:1 by increasing accuracy and reimbursement for services, improving clean claims rates and reducing denials.

PwC is excited to announce our NextGen IP SMART product which is designed support clients on their journey to the cloud, whether moving one application at a time or embarking on a large-scale cloud transformation. With our new key functions and features, SMART will increase the value to your organization by streamlining processes with flexibility and client customization.

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Managed Services

Established in 2002, PwC's Revenue Cycle Managed Services offers revenue cycle solutions, including standalone point solutions and customizable full function outsourced services. PwC specializes in providing business process services across various functions (patient access, financial clearance, coding, insurance billing/follow-up and self-pay collections) for hospitals, medical groups, and payers in a surge, partial, or full function outsource capacity. PwC’s Revenue Cycle Managed Services is rated Best in KLAS for extended business office services.

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Contact us

Shannon O’Shea

Shannon O’Shea

Principal, PwC US

Scott Ramer

Scott Ramer

Principal, PwC US

Mark Fracas

Mark Fracas

Managing Director, PwC US

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