Revenue cycle management is a key as well as complex function that helps in improving revenue generation for healthcare enterprises. Vendor-sponsored revenue cycle management solutions is a proven way to improve reimbursement and keep the cash register ringing. However, it is a daunting task for decision makers to choose the best out of a supply pool concentrated with top-notch revenue cycle management companies. Here’s a look at key factors that must be considered while partnering with revenue cycle management companies:
Efficiency in denial handling and claims processing- Experienced revenue cycle management companies are expected to deal with denials in payments in keeping with the dynamic changes in the industry. This is critical in ensuring revenue enhancements. They should have the expertise to support, identify, and determine payment and collection trends as well as comprehend the root cause of denials by comparing the existing information with the previous data.
Minimum TAT- Typically, the billing and payment process involves multiple parties who are responsible to execute a gamut of tasks which are filing of claims, timely collections, denial management tasks, and processing of appeals. The true success of revenue cycle management companies lies in their ability to ensure a faster TAT despite executing an extensive range of critical tasks.
Technology adoption- To begin with, enterprises must ensure that the tools used by an RCM vendor are compatible to their operational environment. A fully automated vendor who have a robust practice management system in place is among the highly preferred revenue cycle management companies. They are expected to leverage billing applications that support the transition of a healthcare operation to newer diagnostic codebooks. However, it is critical to do a cost-benefit analysis while selecting a vendor in terms of their technology adoption.
Effective communication- It is extremely crucial that RCM vendors keep the communication channel active to feed enterprises with regular and proactive updates on the process that was outsourced to them. This will enable enterprises to determine the fact that whether they are being able to meet their business needs while keeping control on the process. This will not only provide a boost to the financial prospects but also motivate vendors to stick to their SLA terms.
The Best ROI-It is critical for small and medium sized enterprises with stringent budgets to prudently choose revenue cycle management companies based on their pricing. Prior to partnering with an RCM vendor, they must clearly assess the collection cost which has a large role to play in their return of investment.A 100% is considered as the best collection rate. Despite promises made by vendors to boost collection and improve revenue, the ROI must always surpass the budget set aside for RCM vendors.
Ideally decision makers should consider these factors to filter out prospects from a teeming pool of revenue cycle management companies. They must make a careful selection from these prospects solely based on the fact that whether the vendors will be able to meet and scale up to the business needs which can tend to be dynamic throughout a year.
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