It is crucial to always include service metrics in your vendor contracts as it will set clear expectations with your vendors in terms of productivity, skills, quality and customer service.
Jim Rielly, Principal Healthcare IT Consultant, Hayes Management Consulting: As a healthcare organization you may need to provide coverage for ebbs and flows in volume or moving revenue cycle functions to outsource vendors.
In the current global economy, there are more options to outsource components of revenue cycle work than ever before. Some revenue cycle software vendors have built their offering on the assumption that you will outsource key revenue cycle activities to them. Others offer it as an add-on service. There are also many standalone vendors that offer the human component to supplement your staff or in some cases provide a more cost effective staffing solution. Regardless of your needs, it's important to negotiate a contract that protects your investment and outlines the level of service expected. The contract should have well-defined productivity, skills and quality metrics.
It is equally important to include a defined auditing process regardless of whether you audit yourself or ask the vendor to provide auditing services.
For example, if you are outsourcing charge entry work, consider incorporating the following metrics:
• Productivity metrics. Data entry resources need to enter 160 charges per eight-hour day.
• Skills metrics. Typing speed 50 words per minute with 97 percent accuracy.
• Quality metrics. Based on the agreed-to workflow 97 percent of audited charges are entered accurately.
To set fair metrics, you need to have established internal baselines. Outsourced resources don't have "shout over the cube" access to your experts, so you may want to reduce your internal metrics a bit to account for communication issues and/or time zone differences. You also need some teeth in the contract. Provide a reasonable time frame for the outsourced resources to ramp up to your expectations and have financial penalties in place if targets are not consistently met. Finally, include customer service metrics like time to resolution for issues you raise with your vendor.
If you would like to share your RCM best practices, please email Carrie Pallardy at cpallardy@beckershealthcare.com to be featured in the "RCM tip of the day" series.