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Pitfalls to avoid when switching your RCM solution

Quanum Insights

When outsourcing your billing to a revenue cycle management (RCM) vendor, it is important to continually monitor performance. Laurie Morgan, partner and senior consultant with Capko & Morgan, recently shared information about opportunities for physicians to upgrade their practice management technology in her webinar, Choosing or switching your RCM vendor: avoid pitfalls, maximize upside.

“It is critical to have the most efficient workflow in place to prevent problems from occurring before reaching the point of billing,” said Morgan. “Addressing issues at the source helps enable your practice to provide the best patient experience.”

Morgan shared 4 pitfalls to avoid to help ensure your RCM vendor is performing as expected:

  1. Patient complaints. If patients are complaining about statements being inaccurate or arriving too long after the service is provided, those can be red flags. Morgan reminds practices to keep an eye on patient complaints and to follow up if the RCM provider is slow in sending out statements or not sending statements out regularly. You want patients to feel like they are receiving quality service and have the confidence that billing is accurate.
  2. AR growth. AR growth is among the top metrics Morgan recommends practices watch carefully, and that any issues are researched and resolved quickly. “If patient accounts age too much, it becomes less likely that they will ever be paid,” said Morgan. “Keep in mind that your specialty matters, though. If you’re sending out larger bills and patients are paying them off gradually, that can affect total AR. To evaluate your practice AR trends, understand how aging buckets are calculated in your system, and learn the benchmarks that relate to your practice.”
  3. Time to bill. Morgan cautioned that it should not take longer than 24 to 48 hours for bills to be sent once the claims information is received. “Set a process so that if this problem is flagged, you respond immediately,” said Morgan. “And make sure your technology is set up to automate as much of the process as possible.”
  4. Adjustment/write-offs. There should be no surprise write-offs or unapproved adjustments. It is critical to set policy with your RCM provider to establish approved amounts and reasons for write offs or for sending patient accounts to collections.  

Above all, Morgan reminds practices to collaborate with your RCM vendor and have a goal of communicating regularly to learn and improve together to mutually achieve the best results.

We hope you enjoyed this series sharing more information about Laurie Morgan’s webinar, Choosing or switching your RCM vendor: avoid pitfalls, maximize upside. Tune into her webinar, and be sure to check out any previous posts you may have missed:

 

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