5 Questions To Ask Before Outsourcing Your Revenue Cycle Management

Posted on October 25, 2021 by Kylene Ordway

As healthcare costs rise, and administrative burdens grow, healthcare providers are increasingly looking to outsource parts of their services to alleviate some of the strain. If your organization is considering outsourcing your revenue cycle management, you’re not alone. By 2023 the outsourced revenue cycle management market is expected to be worth $23 billion.

Outsourcing is not just a great solution for improving your bottom line. With less time spent on administrative tasks, healthcare providers can get back to the work that matters most — treating patients and providing high-quality value-based care initiatives.

The right outsourced RCM provider can keep your organization current with coding and billing requirements, provide updates and education to help staff stay informed, provide technology that automates tasks, and overall improve the patient’s financial experience.

Before choosing an RCM vendor, organizations should do their due diligence. It’s important to find a vendor that provides the support and software to efficiently improve your business.

Sheldon Pink, Vice President of Revenue Cycle at Luminis Health explains the importance of screening vendors. Patient balances carry a significant liability to your organization, and the vendor you select should uphold your organization’s values. It’s important to remember that providing a great patient experience can outweigh the details of collecting funds.

To find your ideal vendor, here are five questions to ask before you begin outsourcing your operations:

1. What level of access will my team have to patient information?

Regardless of whether you are looking to entirely outsource your revenue cycle management or just parts of the process, your team should always have access to the information that they need. Hiring an outsourced vendor should simplify your workflows.

Even with outsourced RCM billers, medical staff should be able to find and view all of the codes and patient information they need at a moment’s notice. Gaining access to important information should become less complicated with an RCM vendor. Without full transparency to records, your organization may not have an accurate picture of the work being completed.

2. How much downtime is required to understand and learn your system?

One of the major concerns for many healthcare organizations is not having a lot of time to spare learning a new software system. Finding an RCM vendor that has a software system that is clear and easy to use is vital to minimizing any downtime.

It’s important that your team is given adequate training with the new software and that they have access to someone who can answer any questions along the way. As your organization already has a software records system in place, choosing a vendor that has had experience working with your system can also be a good idea.

3. How knowledgeable are you about my industry and my customers?

Ask your potential RCM vendor about what they know about your industry, the specific problems your organization faces, and any future trends or problems that you see arising.

Additionally, speak to your vendors about how they plan to uphold your company culture and values. If your healthcare organization prides itself on customer service, how will each vendor ensure that patients are followed up in the same friendly, helpful tone your staff would use when chasing late payments? How can they ensure your customers are as satisfied with an outside vendor ringing them, as opposed to your staff who may know patients from face to face interactions?

Equally important, says Mr. Pink, is trust that the vendor can adapt to changing environments and levels of technology.

4. Do you offer any additional services?

Ask for a comprehensive list of the services that each vendor is supplying. This way, your healthcare organization can easily compare one RCM service against the next and eliminate any that do not meet your requirements. A vendor may be able to improve more parts of your RCM system that you weren’t initially looking to outsource. Unless you ask, you may not know what else they can help you with.

Talk to each provider about the parts of your processes that often get forgotten about. How can they help you with the piles of paperwork that usually never get filed, or the bottlenecks that leave your staff frustrated at the end of the day. A good vendor will have a solution for all parts of the RCM process, not just one or two areas of improvement.

5. How are performance reports generated?

Performance reports from your RCM vendor are highly important. They are, after all, the proof that your vendor is working hard plugging the holes in your revenue cycle, looking for improvements, recovering money that would previously be lost in the cycle, and keeping patient satisfaction high.

A good vendor will offer regular reporting, and make sure your staff understands these reports. Regular reporting provides you with the knowledge of how their services and software are impacting your organization.

Not every vendor will provide regular reporting, and some vendors will leave reporting up to your staff. The benefit of consistent reporting is that your organization doesn’t have to worry or risk that the reporting will fall behind and never get done.

Additional Questions to Consider

Mr. Pink advises asking potential RCM vendors the following for even further due diligence.

Who are your current clients? This determines if the vendor can manage the size of your health system. Also, identify the states that the vendor is currently working in for their client base.

How long will it take you to absorb my business? This question pinpoints whether the vendor understands your operation thoroughly. There are many companies that purport the ability to absorb new clients with no staffing available. This will be an obstacle at transition.

What determines your rates? Determine if the vendor has true underlying factors related to quality or are simply seeking new business.

With these questions, your organization can find an RCM vendor that fits with the needs and values of your staff and patients, and deliver outstanding improvements to your bottom line.