- Home
- The Excalibur Method
The Excalibur Method
Three sevens. The Pillar Approach diagnoses the organization. The 7 Methods are the revenue cycle operating model. The 7 Principles are the discipline behind the DDPM in our name. Enough here to show the thinking; the full playbook comes with the engagement.
Five pillars stand the structure up.
Project Management is the ceiling. Governance is the foundation. The Readiness Assessment scores each one from 1 to 10 and tells you which to address first.
Revenue cycle functions must report to revenue cycle leaders.
Skill misalignment surfaces as rework and turnover cost.
Undocumented processes do not survive turnover.
Technology must serve process, not the other way around.
Leading and lagging indicators, every day, at the payer level.
For a lean, short-staffed hospital team, the most common fracture is Structure or Process: front-end functions reporting outside revenue cycle, or workqueues with no cross-functional map. That is usually where we start.
The revenue cycle operating model.
One size does not fit all. An engagement can begin at any single method, or all seven.
01B41C: Before the First Cup of Coffee
The discipline of measuring, and managing to, key leading and lagging indicators on a daily, weekly and monthly cadence.
02Front-End Financial Securement
Most denials are decided before the patient discharges. This is the top net revenue killer in the industry, and the method that addresses it at the source.
03Cross-Functional DNFB Management
Discharged, not final billed is a shared segment of the receivable, managed by several stakeholders, not just HIM and Coding.
04Dispositional Receivables Management
Segmenting and stratifying the receivable to tell leadership the story. An end to working accounts one by one.
05Predictive Account-Level Forecasting
Predict the outcome of every balance, then use the data to stratify the receivable and patient engagement. The right account, at the right time, with the right strategy.
06Payment Discrepancy Resolution
One hub that manages any payment at variance to expected reimbursement: denial, credit or underpayment.
07Triangulation A/R Valuation
An account-level valuation that gives Finance multiple perspectives on the net collectible value of its largest asset.
The discipline behind the DDPM.
Data Driven Performance Management is not a dashboard. It is seven habits, run daily, that turn a receivable from a static balance into a narrative you can act on.
01Single Version of the Truth
Ends the paralysis of four leaders holding four different reports on the same problem, none of which tie to each other or to an objective source.
02On Demand
A decision made on last week's data is made too late to change this week's outcome.
03Get to the Bottom of It
Aggregate metrics say a problem exists. Granular metrics say where it is.
04Dispositional
Turns the receivable from a static balance into a narrative you can act on.
05Exception Driven
Managing by defect.
06None Driven
Managing by what did not happen.
07Direct Cash Management First
Reduce or eliminate meetings that are not directly connected to cash performance.
Revenue cycle terms, defined for Finance
- Contractual allowance
- The difference between gross charges and the amount a payer contract says the provider will be paid. Allowance volatility is the enemy of a predictable close.
- Realization rate
- Net revenue collected as a percentage of gross charges. Excalibur's Eastern Washington client partner moved from 27 to 32 percent.
- DNFB
- Discharged, not final billed: accounts where care is complete but the claim has not dropped. A shared segment of the receivable, not an HIM problem alone.
- Dispositional management
- Working the receivable by the disposition of each account (what will happen to it) rather than one account at a time or by aging bucket.
- Net collectible value
- What the receivable is actually worth after contractuals, bad debt and uncompensated care; the number auditors and boards care about.
- Leading and lagging indicators
- Leading indicators (registration quality, authorization rates, DNFB days) predict cash; lagging indicators (cash, net days, A/R over 90) confirm it.
- Payment discrepancy
- Any payment at variance to the expected reimbursement: a denial, an underpayment or a credit balance. One hub resolves all three.
- Month-end close
- The process of finalizing the revenue cycle's contribution to the financial statements. Excalibur delivers a Revenue Cycle Income Statement in two business days or less.
Questions about the method
What are the Three 7s?
The Three 7s are Excalibur's intellectual property: the Pillar Approach (an organizational diagnostic of five core pillars, with Project Management as the ceiling and Governance as the foundation), the 7 Methods (the revenue cycle operating model) and the 7 Principles of Data Driven Performance Management (the philosophy the AskMerlin platform operationalizes daily).
Can we start with one method?
Yes. One size does not fit all. An engagement can begin at any single method, or all seven, and the Readiness Assessment tells you which pillar to address first.
What is B41C?
B41C stands for Before the First Cup of Coffee. It is the discipline of measuring, and managing to, key leading and lagging indicators on a daily, weekly and monthly cadence, so revenue cycle leaders see the story of the month before it becomes the month-end surprise.
What is Triangulation A/R Valuation?
Triangulation A/R Valuation is an account-level valuation that gives Finance multiple perspectives on the net collectible value of its receivable, using more than one method so reserves are defensible to auditors, boards and lenders.
See where your organization sits on the maturity curve.
The Readiness Assessment scores you against the Pillars and the Principles: Absent, Emerging, Practiced or Hardwired. Then it tells you which pillar first, what hardwiring requires, how long it takes and what it costs.