How do you communicate and collaborate with your revenue cycle vendor to ensure alignment and accountability?

For any healthcare organization it is critical prior to engaging with a RCM company is to ensure they have the foundational skills and competency in your specialty to perform the work. A provider is not a provider. How you approach things for a family practitioner is not the same for how you approach RCM for a neurosurgeon. Additionally, you need to verify the existence of a compliance plan for the the third-party billing company to ensure their understanding of complex coding and documentation requirements and their establishment of a culture of compliance. Finally, ask for references and more importantly call them and ask the good questions. This is the difference between surviving and thriving!

Clearly outline your objectives and what you expect from the partnership. Set measurable goals, timelines, and key performance indicators (KPIs) to ensure both parties understand the desired outcomes and can work towards them effectively.

When you outsource your RCM you give up control to a significant degree so ensuring you have open lines of communication is critical to the overall success for the partnership. As the client (the one paying the bills) you have a right to expect / demand performance. It should be the vendor reaching out on a daily, weekly, and monthly basis with updates. As the client, you should never have to chase someone you are paying for services and the moment you do you need to re-establish expectations.

Maintain regular communication through meetings, updates, and reports. Use multiple channels such as email, phone calls, and video conferences to ensure timely and clear information sharing. This helps in staying aligned and addressing any issues promptly.

Foster a collaborative environment where both your team and the vendor work together to identify and solve problems. Encourage brainstorming and innovation to improve processes and address challenges, ensuring continuous improvement in the revenue cycle.

The best RCM companies utilize advance predictive analytic modeling to target potential risk areas and mitigate threats. The best RCM companies know how to sample claims, audit them with precision and provide feedback to providers and leadership on corrective action to ensure only clean claims go out the door. Collaboration in any partnership is critical. Remember, you are only as strong as your weakest link, and it should not be your RCM vendor!

If your RCM vendor has more excuses than Carter has pills for why things are static, it's time to re-evaluate the relationship. In a world where everyone is more concerned about feelings than results, you have to hold people accountable for what their roles and responsibilities are and to hold them responsible for not meeting goals and expectations. If your vendor is not working hard for you, you need to move on!

Monitor the vendor’s performance against the agreed-upon KPIs and goals. Conduct regular performance reviews and provide constructive feedback. If issues arise, address them promptly and hold the vendor accountable for making necessary improvements and meeting your expectations.

When it comes to renewal of contracts with vendors the negotiations should be based on past performance more than future expectations. If your vendor has fallen short, even by a minuscule amount, they failed you and renewing may not be the way to go... However, even with the best efforts some RCM companies fall short, so before you go off the deep end by not renewing your contract, make sure you understand all the reasons why things didn't meet or exceed the original terms. Some of it could be your fault and as such, you vendor should not be penalized.

Trust is earned, not given... the fact that you are outsourcing your RCM means you are taking a leap of faith in their abilities. Performance and communication are the only ways to build a solid foundation and to ensure longevity of the relationship. Reward strong performance with shows of gratitude... Provide Google Reviews, send a basket of brownies or cookies for the team to enjoy. If your RCM company has exceeded expectation at the time of contract renewal offer a multi-year extension but make sure you have strong opt outs in the event things go south. Communication is the key to success for building strong rapport with your outsourced RCM team so keep the emails, calls, and video meetings coming. It will pay off in the end!

You might also consider quarterly reporting in a format that has been created by your healthcare organization based on areas of importance. As an example, it might include auditing and scoring of account reviews. It's also important to ensure that if you are comparing agencies that you are indeed measuring apples to apples. Often times, vendors have different reporting and ways of computing performance that might not necessarily be the same as a competing agency or what you might assume makes up the equation.