Quest Diagnostics is excited to present this article by Laurie Morgan. In her recent webinar, Choosing or switching your RCM vendor: avoid pitfalls, maximize upside, Laurie shares information about opportunities for practices to upgrade technology, whether switching RCM vendors or outsourcing billing for the first time.

The COVID-19 pandemic placed a spotlight on key issues in practice administration related to front office technology and the demand for contactless workflow. Practices had to be flexible and pivot to ensure they realized maximum revenue during such uncertain times, while using this opportunity to rethink their processes and evaluate how to improve revenue cycle management (RCM).

If you are considering changing your RCM provider or outsourcing for the first time, it is critical to understand your current situation and analyze your needs to ensure you choose the right partner to help maximize your investment.  There are several signs that may mean it’s time to consider alternative RCM solutions.

Insufficient technology

If the pandemic made you realize you do not have the technology you need, now may be the time to look at a new RCM provider. In fact, you may be able to solve multiple problems by making a change.

Technology needs to look for when you are shopping for a new RCM platform include:

Eligibility verification and cost estimates before the visit. Ask potential RCM vendors if functionality for eligibility verification and estimating can be delivered either directly by the practice management and billing system or if a third party add on is available.

Electronic statements and online bill payment. Make it easy for patients to pay online so that you will get paid more quickly and in full.

Credit card on file. A secure and private credit card on file solution is valued by patients, especially when balances are larger and need to be paid over a longer time.

Electronic data collection. Patients having the ability to complete forms prior to their appointment enables information to be entered directly and accurately into your system.

Staff redundancy

Staff redundancy is one of the most powerful reasons to outsource all or part of your RCM. If you are relying on single person inside your practice to handle your billing and that person moves on or needs to take an extended leave, you could be in very difficult situation that can have huge impact on your revenue and profitability. Outsourcing can help ensure that more than one person has knowledge of the billing processes for your practice.

If you have gaps in your technology solutions or staffing needs, these are signs it’s time to consider alternative RCM solutions.

Watch for future posts in our series on the following topics:

• Reasons to consider outsourcing, even if you have an in-house biller
• Making the switch: Tips for choosing a new RCM partner
• RCM is a team sport—even when outsourcing billing
• Pitfalls to avoid when moving or switching your RCM solution

Laurie Morgan, MBA is a partner and senior consultant for Capko & Morgan. Tune into her webinar, Choosing or switching your RCM vendor: avoid pitfalls, maximize upside.