As administrative burden has increased due to claims processing, narrow networks, and authorizations –it is important for providers to think differently to improve performance while reducing costs and complexity. Often this means leveraging technologies and analytics, as well as improving operations and with this, a transition to a new RCM partners.
The change to a new RCM partners is often seen as daunting and disruptive, and sometimes this is just enough to delay consideration despite the lost opportunity cost. But, how can you avoid disruption across all areas and smoothly transition to a partner that provides robust revenue cycle management performance?
Planning for the Transition of RCM Partners?
Traditionally healthcare practices have been quick to blame RCM vendors for disruptions that occur during a transition, but in reality, both are responsible and accountability is key.
In preparing for RCM transition it is imperative to set clear expectations, define responsibilities and provide full transparency. An RCM vendor is only as good as the information they are provided so it is crucial to confirm understanding of the information provided to avoid delays and ultimately any disruption to cash flow.
From the documentation of processes and workflows, to defining reporting needs, and providing full system access to eliminate any potential roadblocks – practices and vendors need to communicate extensively. And, while a lot of focus is typically on the external vendor, internal preparation is just as important.
In advance of transition, buy-in from stakeholders on planned changes and decisions on implementation of timelines and transition plans need to be achieved and approved. As the goal is always to have no cash flow interruption or delay – this requires cooperation with internal personnel, external partners and transparency across technology.
Often this means internal trainings and increasing access to software for vendors. This also might mean staggering implementation – from billing to AR management. Once these details are decided upon, it is vital to make sure both parties – the vendor and the practice, sign off on an implementation plan and all finalized standard operating procedures (SOP).
Data and Ongoing Management
An RCM vendor is truly a partner, after transition and through implementation is just the beginning. Thus, ongoing management, tracking of data and defining of key performance indicators are hallmark components for a successful RCM transition.
Through the entire process of transition, data needs to be tracked and analyzed because data tells the story of what is actually happening. The data that should be included and closely managed ranges from operations data to financial data and from this KPIs should be set. These KPIs should then be used to identify opportunities for change and improvement by both practices and vendors.
Following implementation, ongoing management is essential and this means a weekly scheduled meeting with an agenda. Each meeting should have takeaways and deliverables that can be defined and executed, and expectations and data points should be reviewed. This weekly cadence is key for communication, review of KPIs and additional reporting, and overall accountability for a successful partnership.
Thinking about changing RCM vendors or preparing for transition? Lisa Boyd, Senior Director of Revenue Cycle Management at vybe urgent care and Owner of Boyd Healthcare Management and Consulting, leads this on-demand educational session covering every step of the transition process including:
- Change Management
- System Access
- Transition Planning
- KPI Tracking
- Ongoing Management
In July of 2017, Medical Economics conclusively reasoned that, “On the off chance that you work a clinical practice, you ought to re-appropriate.” They detailed that rethinking can be carried out to reduce inner expenses, center representative time around urgent consideration conveyance, and save time for patient consideration the executives. By far most of suppliers are displayed to have a good inclination about their reevaluating connections.
Each training needs to take a gander at interior capacities and financial plan availabilities to figure out which approach is best for meeting its RCM needs.