Hospitals and health systems are under constant pressure to improve financial viability as margins become tighter. At the same time, these hospitals are having difficulty recruiting and training revenue cycle staff. This has forced many healthcare financial executives to re-evaluate the structure of their revenue cycle department and turn to third parties for help. However, understanding all the different RCM solution options can be confusing and choosing the right partner is critical for success.
Here are the top questions you should be asking the companies you are considering partnering with for your revenue cycle needs:
- Do they offer insurance eligibility verification and if applicable, retroactive eligibility verification?
- Are they experienced with all major EHR platforms?
- What is their pricing model? Are there hidden fees or costs that will impact the total cost of service?
- What key performance indicators are they tracking to make sure that they are making improvements in your financial health? Do they present these KPIs in an easily-digestible format that allows you to make quick and informed decisions?
- Are they transparent? Do they have a process for keeping you up-to-date on what’s going on? Are the reports that they provide helpful and accurate?
- Do they offer benchmarking and analysis that provides actionable information to your organization?
- Do they monitor payer contracts for underpayments? Will they manage the appeals process or do they plan to leave that heavy lifting to your staff?
- Do they have specialty coders on staff? You should also make sure they have significant experience in revenue cycle management. Vendors with years of experience will have sophisticated processes and the ability to provide expert analysis.
- Do they have references and case studies? Another trademark of a great RCM vendor is great customer success stories. Ask for case studies and references to help you vet those on your shortlist. Make sure you take the time to call and talk to the references to make sure the vendor will be a good fit for your organization.
- Have they been in business a long time? Look for a partner who will be around for the long term. Ask about turnover and average length of employee tenure at the company.
This checklist will provide your healthcare organization with the ultimate tool for screening vendors. Many partners are not a good fit if they can’t satisfy most, if not all, of these requirements. If you follow these guidelines and select the right revenue cycle management partner for your organization, then you should realize:
- Increased cash flow
- Decreased bad debts
- Reduced operating costs
- Improved patient satisfaction