What to look for in a revenue cycle management provider
Regardless of the business you’re in, the capability to efficiently capture, manage and collect revenue is critical to success. Many healthcare organizations are turning to revenue cycle management(RCM) vendors and their high-tech software applications to help them achieve consistent profits. The demand from home health, physician offices and hospitals has resulted in a consistent stream of new RCM companies providing these services. But how do you decide on the RCM platform that’s right for your healthcare operation? Here are the top five things to look for in a revenue cycle management provider.
1. Comprehensive, customizable applications
One of the first things you should look for in a revenue cycle management provider is a full range of RCM components. Depending on your organization’s size, your current staffing and your top priorities, you may need a customized application that is just right for you. A company that offers an all-or-nothing approach won’t have the flexibility to meet your specific needs. In addition to all-payer claims and remittance processes, you may need physician scheduling or Medicare eligibility verification at some point. Ideally, you want to choose an RCM vendor who can help you identify your needs and then be equally happy to partner, to consult, to co-manage or to fully outsource their revenue cycle management. Plus, if you start small, you want a provider who can easily add-on the services you need as you grow.
2. Technology and security
Rapid technology changes are common in healthcare. You’ll want to make sure you hire a revenue cycle management provider who offers the most productive and efficient technology, including cloud-based software that’s reliable, easy to use and connects to your existing software. You’ll also want a vendor who stays ahead of changes in technology, modifying their products to bring the best to their customers.
3. Trust and transparency
Your revenue cycle management provider will be critical to your organization’s overall success. That’s why both trust and transparency are so important. Do your homework and read reviews, look at customer testimonials and business case studies. Investigate the company how long have they been operating? Who are their owners? How involved are they in the industry? What is their financial health?
With regard to revenue cycle management software, will you have full access to manage claims and pull reports? You should have transparency when it comes to knowing and understanding the work that is being performed.
4. Effective software processes
When choosing a revenue cycle management provider, you want to make sure the automated processes implemented by the software are effective and easily customizable to your specific needs. That means your RCM platform needs to support rapid turnaround time for claims, as well as a low percentage of denied claims and a process for resubmitting those claims. Find out what the provider’s denial management strategy is what percentage of claims are denied in the first place and how many will be resubmitted? You want your RCM vendor to take an active approach to quickly submitting claims and have the processes in place to appeal denials.
5. Personalized customer service training and reporting
Get to know your potential providers and know the person who will be directly responsible for ensuring the success of your revenue cycle management program. Will that person run, analyze and review reports with you on a regular basis? Are they or other customer service personnel available 24/7? What is their level of expertise in working with healthcare systems like yours?
Part of great customer service includes proper onboarding of the new system with current employees. Make sure your RCM vendor provides onsite training to help you transition to their services.
Discover the difference with Inovalon
When searching for the best revenue cycle management provider for your physician practice, hospital or health system, consider Inovalon’s provider solutions. You’ll find we score at the top of every important criterion you need for a high-quality RCM process. We understand your goal is to maximize revenue and we have the processes and technology to help you do just that. Streamline your workflows, avoiding coding errors and reducing denials means you get paid faster. And when you expedite your cash flow, you’ll have more money in the bank. Improving efficiencies enables your organization to do what you do best take care of patients. Call 888.895.2649 and let us throw our hat in the ring as your revenue cycle management software provider!
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