Choosing an RCM partner: What your practice should look for

Billing and the revenue cycle often take a backseat to everything from patient care to choosing the best EHR, but from a business perspective, there's nothing more important than the bottom line. If the revenue stops flowing, patient care stops next. 

If your healthcare practice is one of the many practices suffering from unpaid claims, aging AR, denials, and other burdensome, time-consuming struggles; it's time to ask for help.

On the surface, there are many revenue cycle management (RCM) companies who would offer to help, but, as you might expect, these RCM partners are not created equal.

What do you need in an RCM partner?

Before you reach out to select the best RCM partner, you have to look inward. Look for pain points and red flags among your practice's administrative workflows and reimbursements. You're going to want to find an RCM partner that can address all of these issues for you.

Figure out what your success metrics will be. For example, say that your current collections rate is 65% and you'd like to see it at 85% to be considered a success. When you evaluate your potential RCM partner, offer these metrics and goals to help establish if this specific RCM service will be right for you.

Maybe you want to shorten your billing cycle—from the time of service to the time of payment—from six weeks to two weeks. The right RCM partner can not only help you reach or exceed your goals, they will be able to explain the process of how they will do that.

If you're unsure of what you need or where your healthcare practice is struggling the most, a good RCM partner—such as our ARIA RCM Services—offers a financial assessment as part of the vetting process to help you pinpoint problem areas.

A comprehensive financial assessment checks your key operating metrics to determine the overall health of your practice including days for revenue outstanding, collection rates, charge posting, charge and payment lags, and patient receivable levels. This examination helps explain how and why your practice is performing the way that it is.

With an assessment from ARIA RCM Services, you'd receive the results as a detailed report and a 30-minute consultation. The assessment helps you:

• Determine the health of your practice by identifying areas of revenue leakage
• Benchmark your performance against industry standards
• Provide a roadmap and set of best practices to maximize your revenue per encounter

This insight helps you identify what services would have the most impact on your revenue cycle. For example, you may find that a large portion of your accounts receivable is over 120 days old. If this is your main concern, a good RCM partner will focus on just this portion of your revenue cycle, helping you bring down those numbers and collect outstanding funds.

10 questions to ask during your search

Once you’ve narrowed the field of potential RCM partners, the next step is to evaluate and compare competitors according to your specific criteria and needs.

To help with this, we've published a list of the ten questions to ask any medical billing company. Consider this list along with the internal gaps you've already identified and choose the RCM partner that is best for you.

Account management is key

Finding an RCM partner that is hands on from start to finish is going to lead to a bigger return on investment for your practice as opposed to a service that only submits bills on your behalf.

Pick a revenue cycle management provider that views your healthcare practice as more than just a transaction. Choose one that is looking to partner for the long term. You can determine intentions by asking leading questions like:

• Will I have a dedicated account executive? It's important that you have a point person that you can reach out to at any time to answer any questions you might have. Your account executive should serve as an advisor providing guidance and support on how to continually improve your revenue cycle.
• How often do I meet with my account executive? Regular check-ins with your RCM partner are a must. Monthly check-ins will help you examine your performance against key metrics and set goals for improvement.
• What kind of reporting is provided and which metrics are tracked? Look for an RCM partner with an analytics engine that not only analyzes your data but compares it to healthcare industry benchmarks and offers insights on how to improve performance.
• Will I be able to monitor progress? The goal of your healthcare practice's RCM partner is to offload the operational burden from your team. However, you still want to keep track of what is going on. Understand what type of visibility you will have into your partner's work. Ideally, you want to choose a partner that works within your current system, so you have 24/7 visibility.

The purpose of an RCM partner is to make the business side of your healthcare practice easier, so it’s important to find a service that provides excellent account management and reporting.

Choose an experienced RCM Partner

Finally, be wary of fly-by-night services and companies that are hopping into a market they don't fully understand in an effort to make a quick buck.

Look for an experienced RCM partner. Find out how long they have been helping physicians and remember that experience matters.

Ask for testimonials from satisfied clients and a full list of references. Follow through on contacting those references and understand that any company's past performance will be a great indicator of how they would help (or not help) you in the future.

Ready to get started? Learn more about ARIA RCM Services and contact us about your free assessment today.