Robert Kowalick, Founder and CEO of Revenue Cycle Solutions, LLC (RCS) and Ascend Solutions, LLC, was invited to join Stride as a guest on its educational webinar series for a live session titled The Revenue Cycle Complexity Black Hole: What's Standing Between You and a More Valuable Practice.
He was joined by Craig Brasington, Vice President of Revenue at Stride, for a conversation built for physical therapy and occupational therapy practice owners who want to understand where their revenue actually breaks, and what it takes to fix it.
The recording is available now.
What the session covered
Every practice has a revenue cycle black hole. You can't see it, but you can feel its pull through claims that stall, staff who waste time, cash that arrives late or not at all, and costs that escalate. The question isn't whether your practice has one. It's how big it is.
Here is what most practices can't know on their own: what the actual root causes of their revenue problems are. RCS and Ascend have been answering that question with data for eight years. What the data shows is consistent. The majority of the complexity putting revenue at risk originates inside the practice, external to billing, long before a claim ever reaches a biller. It starts in places like patient registration, verification of benefits, authorization management, clinical documentation, and coding.
In the current national roll-up of that data, 71% of all revenue cycle complexity is generated internally to the practice but external to billing; 10% comes from payers; 13% comes from systems such as the EMR, practice management software, and clearinghouse; and 6% is generated inside the billing process itself. That distribution has shifted over the eight years of measurement. It used to sit at 78/14/4/4. Ninety-four percent of revenue cycle complexity is external to billing.
Billing doesn't create the black hole; it absorbs more of the pull than any other function in the practice. It is the one function affected by every other function.
In the session, Craig and Robert pull back the curtain on what's actually driving revenue cycle complexity, why it stays invisible until it's measured, and why the old fix of hiring more people has never scaled as a solution.
Who should watch
This session is for practice owners and leaders who bill in-house or outsource, and who want the math behind their revenue cycle: what it takes to convert provider time into cash faster, without burning out the people doing the work. If your accounts receivable is climbing and you have been treating it as a billing problem, this is the reframe worth an hour of your time.
Frequently asked questions
What is the revenue cycle black hole?
It's the way we describe Revenue Cycle Complexity (RCC): the errors, omissions, and structural issues across a practice that consume time and revenue without limit. Like a real black hole, it can't be seen directly. It can only be understood by measuring its impact on the work around it.
Where does most revenue cycle complexity come from?
In our current data, 71% originates inside the practice but external to billing, 10% from payers, 13% from systems, and 6% from billing itself. That means 94% of it is external to billing. Patient registration is the single largest internal source.
Do I have to outsource billing to benefit from this?
No. The session is about awareness and measurement, not a sales pitch for outsourcing. Whether you bill in-house or outsource, the goal is the same: make the complexity visible so you can reduce it.
Where can I watch the recording?
The full session is available here: https://strideemr.ai/the-revenue-cycle-blackhole-webinar-registration/.