Checklist for Selecting an RCM Partner

January 16, 2023

As the realities of the challenges of ‘The Great Resignation’ and the COVID-19 pandemic set in, many practices are finding it more cost-effective to leverage third-party vendors to manage their revenue cycle management (RCM). 

The right RCM partner can help improve your practice’s overall performance. But how do you know which vendor is right for your practice? In this article, we will review why RCM is important for any healthcare practice and what providers and administrators should look for when choosing the right RCM partner.  

Why RCM Matters (and How an RCM Partner Can Help)

RCM is a front-end automation system that tracks payments, billing, documentation, and collections. Having an efficient RCM cycle is essential to keeping practices open for business and providing quality patient care. The goal of RCM is to bill correctly and efficiently in order to maximize reimbursements and, resulting in top line revenue.  

As many healthcare providers deal with a shortage of staff members who are experienced in financials and billing, a backlog of claims from the pandemic, and new demands for reporting and coverage, they turn to third-party RCM partners for much-needed help and expertise. The right partner is there to help you at every step associated with rendering of health-related services and payment collections, customized to your practice to optimize efficiency and reduce costs. 

An RCM partner can help you: 

  1. Maximize reimbursements
  2. Submit clean claims
  3. Lower denial rates
  4. Spend less time in accounts receivable (AR)
  5. Spend more time with your patients
  6. And much more

So, how do you find the RCM partner that is right for you?

To learn more about choosing the right RCM partner for your practice, check out Integra Connect’s webinar, “How to Improve Practice Performance through Revenue Cycle Management.” Hear first-hand the experiences of healthcare providers and managers who chose to outsource RCM to third-party companies and their tips for finding the right fit. 

Top 5 Factors to Consider When Looking for in an RCM Partner

Look for a partner that has:  

  1. Expertise in your specialty: Make sure that the partner you choose knows the details of your specialty, as well as the technology you use. Experience matters, so find a vendor that has a history of direct experience in your specialty area. 
  1. Significant industry knowledge on reporting: The healthcare industry is dynamic and the demands for reporting and coverage are constantly changing. Choose an RCM partner that is compliant and up-to-date on documentation requirements.  
  1. Insights on workflow:  An RCM vendor should offer you more than just maximizing revenue and reimbursements. They should also provide tangible action items and insights on how you can improve and streamline your entire billing and collection system, from your front-end office to the back-end operations. 
  1. Concierge-level support: Good communication and a strong working relationship is key to an efficient RCM process. When your staff has questions or when problems arise, you want to be able to contact your third-party RCM partner quickly. This may mean having a staff member onsite or making sure the company is based in the same time zone. In any case, find a company that is willing to give personal and specific support for your practice’s needs and in the time you need them. 
  1. A plan for the future: The best RCM partner will set you up for future success–whether that means helping you transition from fee-for-service to value-based care or being prepared for changes that are coming down the pipeline. While the focus may be on digging yourself out of the pile of current claims, you also want a partner that will help you navigate tomorrow’s tasks as well. Providing a high-level view and educated feedback of your year-to-year trends can focus and improve your practice, which is key to your practice’s future success.

With Integra Connect’s Revenue Cycle Solutions, organizations can collect and analyze data from different parts of the organization and quickly identify ways to reduce costs, improve outcomes and maximize revenue.

Schedule time with one of our RCM specialists.