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What to look for in a revenue cycle management vendor

The best way to avoid inefficient and exhausting processes is to invest in automation, like most industries outside the healthcare sector. Finding the right RCM can reduce costs, retire repetitive tasks, and allow doctors to focus on providing care to patients.

The healthcare revenue cycle management (RCM) market continues to grow annually, but some small hospitals and clinics are still working with archaic systems and tons of paper, managing their claims manually. Just picture the scene: dozens of complicated transactions a day, each handled individually by overworked staff, and therefore prone to error.

In this chaotic scenario, problems can accumulate: billings with wrong amounts for more or less, patients with no idea what they owe, late payment, etc.

The best way to avoid inefficient and exhausting processes is to invest in automation, like most industries outside the healthcare sector. Finding the right RCM can reduce costs, retire repetitive tasks, and allow doctors to focus on providing care to patients.

This is what you have to consider when looking for a revenue cycle management vendor.

Transparency

Once you’ve determined your practice’s real needs, the next step is to explore solutions. There are many options on the market and you will have to compare suppliers instead of partnering with the first one that comes along.

When researching across different companies, remember that the vendor’s complete transparency in conducting its business is key. Do a thorough first investigation by reading other customer reviews or case studies. Then, talk openly with the vendor and ask the following questions:

  • How long is the company operating?
  • Who are the owners?
  • What is the company’s main difference compared to other suppliers?
  • What are the vendor’s operating practices in areas such as account follow-up, denial management, or customer service?
  • Is the vendor using overseas resources or subcontractors?
  • Does the company offer training during onboarding?
  • All things considered, will the company be able to alleviate your revenue challenges?

Evaluating the answers to these questions before deciding can keep you from making the worst choice.

Full Range, Customizable Features

Revenue cycle management in healthcare involves a series of processes: the ability to automate repetitive claims and billing tasks, an error-free approach when providing pricing information and payment options, ease of collecting and checking patients’ personal and/or insurance information.

Therefore, be wary of the vendor that offers an all-or-nothing approach, since every practice differs in terms of size, staffing, and services provided.

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What you are looking for is an RCM system that is fully customizable to the needs of your practice. For example, you need user-friendly tools. You don’t need that the right tools are “hidden” in the system interface along with dozens of others that you will never use.

The wrong choice will add another layer of delay to the process: you’re going to trade a complicated manual system for a complicated digital system.

Even if it costs a little more, opt for a fully customizable RCM software, where your staff can easily find the tools they need and organize them efficiently.

Top of the Line Security Systems

Data breaches have become a frequent issue in the healthcare industry. Between 2009 and 2020, the US Department of Health and Human Services recorded 3,705 occurrences, resulting in the exposure or loss of nearly 300 million private patient records (nearly 82% of the US population). In 2021alone, there were 686 healthcare data breaches.

The right RCM vendor should be able to deploy sophisticated network solutions against this kind of breach – whether unintentional or the result of a cyberattack. After all, the revenue cycle involves not only patient health data but also private information about payment methods.

Digital security experts suggest the following features to mitigate risks:

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  • Secure connection to the corporate network.
  • Screensavers that automatically log out and require the user to re-enter their password every 5 or 10 minutes.
  • Use of multi-factor authentication (MFA), preferably a three-step process.
  • Possibility to mask payment information to third parties
  • Focus on encryption, especially text messages in response to external requests.
  • Integration with up-to-date anti-virus and anti-malware apps and firewalls, all enabled to continuously scan for threats.

It’s also very important that you choose a company that offers privacy and security training to your staff.

Maximize Your Cash Flow Responsibly

Using technology to improve your revenue cycle is not something that happens in the blink of an eye. Nor is it something you should delay: patients now expect their healthcare professionals to provide clearer information more quickly, and for the billing process to be error-free and delay-free.

The ideal RCM software can determine the value of your patients’ bill, based on the procedures performed and the type of insurance they have, literally in seconds. Trying to calculate the same thing manually would take hours and would still be subject to errors and delays.

So don’t wait until tomorrow to digitize your revenue cycle process. But be careful when choosing the company you will hire, because the quality of the product they offer will be directly responsible for a healthier cash flow in your clinic or private practice.

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