10 Questions to Ask When Choosing an RCM Partner

Managing your practice’s revenue cycle can be one of the most time-consuming and complex parts of running your business. If you are spending more time managing revenue then you are managing your patient’s health, it’s time to engage with a revenue cycle management (RCM) company.

The key is finding the right revenue cycle management company for your specific needs. In this blog post, we will focus on the key questions you should ask potential RCM partners to determine the best fit for your practice.

Before reaching out to select the best potential Revenue Cycle Management partner, you will first want to do an internal needs assessment. Look at each of your billing functions and pinpoint the areas where your practice struggles. You’ll want to select an RCM partner that meets all or almost all of the functions you require to seamlessly complete your revenue cycle—taking into account coding and billing, denial management, patient customer service, collections, compliance, and any other key areas affecting your bottom line.

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. In addition to asking questions that are specific to your practice’s needs, it will be helpful to your decision-making process to have the providers answer the following questions:

  1. Do they offer automated insurance eligibility verification?
  2. Do they have an automated claims scrubber and comprehensive rules engine that is payor specific?
  3. Do they follow up on denied claims? And is there a threshold dollar amount for follow up efforts?
  4. Do they monitor payor contracts for underpayments and assist with the appeals process?
  5. Do they offer patient engagement tools such as appointment reminder notifications (via phone, text, and email) and a patient portal (scheduling, record retrieval, electronic statements, and online payment options)?
  6. Do they offer point-of-care collection tools (check scanning and credit card processing)? And do they send patient statements (paper/online)?
  7. Will they manage patient calls/inquiries?
  8. Are they equipped to interface with your EMR?
  9. What is their pricing model (fee-for-service, percent of collections, or other model)? Are there any hidden fees or extra costs?
  10. What KPIs (key performance indicators) does the firm track to ensure your practice is successful (AR, adjustment yield, charge and bill lag time, first pass rate, CCR, patient AR)?

In addition to the questions above, don’t forget to ask about the companies experience with RCM. Have they been in business and serving physicians for several years, or are they relatively new to the market?

Don’t shy away from requesting a reference check. Ask for case studies and a full list of references. Take the time to call and interview as many of the provided references as you can. Past behavior is the best indicator of future performance.

Last but not least, make your selection and start the implementation process!

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