Choosing the right revenue cycle management (RCM) vendor can have serious implications for the profitability and day-to-day efficiency of your clinic or provider organization. The best vendor will provide the services you need to effectively automate the portions of billing and revenue that you want to deal with the least. However, making a mistake when choosing your vendor could cause a serious dent to your practice, even deterring patients who had a bad experience after billing errors.
Now that ICD-10 is in place, having a RCM company that can meet your needs and uphold your standards of quality is more important than ever. Here are some aspects to consider that help you choose an RCM company that adds value and simplicity to your organization rather than headaches and expense:
Pricing and service plans
With Revenue cycle management companies, comparing prices is often worse than comparing apples to oranges; it can be more like comparing apples to orangutans. Every company offers different service packages that may very well be the same up-front price.
Make sure when comparing companies, you know exactly what type of services you are getting. Some RCM companies only provide software and support, whereas others can handle incoming billing information to produce statements or even manage every aspect of RCM. Consider the services you are getting and weigh them against the cost for comparable services from other organizations.
Another important caveat when choosing an RCM company based on price is that pricing plans can vary just as wildly as service offerings. Some companies will charge monthly fees, others will charge a percentage of the total revenue handled and still others will charge based on the volume of patient bills you expect them to handle. Find a company that does not just have a low price on paper, but one that meets your typical needs at an affordable rate through the long-term.
What happens if the RCM provider you work with makes a mistake or does not live up to its promises? Most providers will want some sort of built-in guarantee that helps them reclaim a portion of lost revenue while paying only for the services rendered as-promised. Not every RCM company can offer this level of guarantee, but many have performance measures or guarantees that ensure your satisfaction once the sales pitch is over.
Software and support
These days, most RCM and billing systems are semi-automated using software. An increasing number of RCM providers are essentially software vendors, or use software as a huge component of their services package.
Finding the billing software that helps you through the ICD-10 transition while being easy-to-use and readily-integrated into your existing patient management systems will be a huge plus. Determine how these systems will be purchased—whether as a one-time fee or ongoing software-as-a-service plan—and also the level of support you have access to should something go wrong.
Going back to finding the right type of payment, one should evaluate the service contract with the RCM company as carefully as the service brochures. Even the best-sounding contract can become a nightmare if it costs an arm and a leg to back out of if you are unsatisfied. Look for a contract that either offers flexible termination clauses or that has short-term commitments to prevent being “married” to an RCM company you hate.
When your RCM contract involves customer interactions, that company quickly becomes a reflection of your own practice. Billing errors that have to be resolved by calling into a call center with amateur-hour employees can strike a serious blow to your practice’s reputation.
Scrutinize your RCM provider’s customer service record, and ask tough questions about how they handle complaints, disputes or questions. Also look for one with a call center located within your region, or at the very least has employees that speak English as a first language. Otherwise, a minor billing problem could get blown out of proportion when a customer has a horrible experience trying to talk with a customer service representative.
How long has the RCM company been in their business? Do they have any high-profile clients? Are their systems engineers or IT professionals certified to handle networking and other complex elements? Can they custom-code entry fields or software features that enhance your RCM process? Do they comply with any standards, like ISO certification?
Answering questions like these can help you evaluate your RCM provider’s “resume” to ensure that they have both the expertise and experience to serve you well.
There are many more elements to consider when weighing your RCM provider options, but these areas should touch upon the most important components of their business. When the company can confidently and resolutely satisfy these needs, then they stand a good chance at offering a great deal of value to both you and your patients.