RCM today: Key considerations for how and when to choose a partner

In the post-COVID, Great Resignation world, revenue cycle management (RCM) operations at specialty and community practices face new hurdles.

That has led some practices to consider bringing-in vendors to support their revenue cycle management needs, including catching up and getting-ahead of claims processing and billing, navigating value-based care and fee-for-service reimbursement models and managing staffing shortages or gaps in experience. 

In a May Becker's Hospital Review webinar, sponsored by Integra Connect, speakers shared why they chose an RCM partner to complement their existing staff and improve their financial performance, what practices should weigh for their decision-making process, and why they would recommend it to others.

Learnings from Karen Hohlman, VP of operations, New York market, Integrated Medical Professionals, an affiliate of Solaris Health, and Cindy Nyberg, CFO of Associated Urologists of North Carolina and managing member of Amaryllis LLC, shared that: 

1. In the current healthcare environment, revenue cycle management is more challenging than ever. While some organizations will look to tackle these challenges themselves, often, these solutions are not really feasible in the long-term. Examples include:   
   • Potential solve: Increase current staff’s workloads. 
     
     Staff are already be overwhelmed and have no capacity for an increased workload. Putting more on their plate could increase burnout and employee turnover.

• • Potential solve: Train existing employees to manage accounts receivable needs. 
    
    This may be possible but in the short-term, these employees will not have the necessary experience with specialized billing processes and technologies to move fast. 

• • Potential solve: Hire additional staff. 
    
    This is not easy in the current labor market, and it takes time to hire and onboard new people and bring them up to speed. Ms. Nyberg said it is challenging to even get someone to show up for an interview.

• • Potential solve: Leverage staffing agencies to backstop staffing needs. 
    
    Staffing agencies are expensive and may not have available personnel with appropriate RCM skills. At best, this is an expensive, short-term solution. 
    
    

2. Ask key questions of a potential RCM partner. The central goal of RCM is efficient collection of revenue earned for the services provided, which is important to keep in mind when selecting a vendor. Also important are key questions such as: 
   
   
   • Does my practice need an RCM vendor that can support a specific project or an RCM vendor that will work with the practice from discovery to implementation, results reporting and auditing? 
   • Does the company have knowledge of and significant experience in your practice's specialty? 
   • Do they document properly?
   • Do they have practice-specific reporting and recommendations to improve overall performance? 
     
     
3. An RCM partner can do more than just extend staffing capabilities. An effective RCM partner can also offer business insights and cost savings while improving operations, finances and practice performance. Ms. Hohlman advised that "We've created a relationship with Integra and Integra has created a relationship with us…and it just makes the work process easier for us."

Faced with more pressures and constraints than ever, practices are having to do more with less. A high-quality revenue cycle management partner can help relieve the burden while providing operational and cost efficiencies.

To view the full webinar, click here. 

To learn more about Becker's virtual events, click here