Part Three of our blog series on coding and revenue cycle management staffing challenges looks at selecting outsourcing and technology partners and benchmarking their success.
When considering an outsourced service or technology partner, trust and experience are crucial to success, as are their depth and breadth of experience, longevity, and proven track record. These qualities indicate coding and RCM expertise and speak to a prospective partner’s ability to understand the complexity of federal and state regulations.
However, the secret sauce in this recipe is the partner’s willingness and ability to provide high-level, high-touch customer service and 24/7 support to meet the evolving challenges healthcare organizations face in this dynamic environment.
Versatility and flexibility are also important. Coding and billing are not traditional 9-to-5 jobs in today’s healthcare system, where weekends and other non-traditional staffing days are just as important as Monday through Friday. Any prospect should be capable of dedicating the appropriate resources to ensure patients have access to the best financial care regardless of any surge in coding volume.
Another critical consideration is whether the prospective outsourcing partner has a deep enough bench of qualified coders to dedicate singularly to your workload. This is essential because when coders are spread across multiple projects, it can impact their ability to understand and comply with your organization’s specific procedures.
Communication is also key to a successful outsourcing partnership by ensuring expectations – on both sides – are met and any problems quickly identified and resolved.
Also, don't forget to ask for and connect with referrals. Ask for their impression of the vendor's reputation for meeting service level agreements, coding capacity per day, week and/or month, best practices, and HIPAA compliance policies.
Finally, establish performance benchmarks that fully address any unique aspects of your organization and the outsourcing or technology relationship. These can be tied to costs to collect, days in A/R, or other metrics. These key performance indicators (KPIs) should go beyond traditional A/R metrics to ensure you have a full understanding of how well goals and expectations are being met. For example, consider assigning cash as a percentage of net revenue or write-offs as a percentage of net revenues as KPIs – or any other priority you deem essential to long-term success.
The right KPIs can help take the relationship with an outsourced coding resource or automation technology vendor to the next level in terms of performance in the areas that are essential to your organization’s growth and/or can help identify paths for improvement in key processes. When these goals are established, request that the vendor share steps toward their success and executive summaries – measures that can help create trust and transparency in the relationship.
That said, there is no one-size-fits-all solution to outcomes and identifying a successful relationship with an outsourced vendor. The key is to take the time to understand your unique staffing challenges and identify the right mix of services and solutions to overcome them.
Revenue cycle management is not static. An outsourced partner must be willing to tweak and adjust services and provide on-demand scalability to meet changing needs.
Part One of this three-part series examined the costly coding and RCM staffing challenges plaguing healthcare organizations today, while Part Two took a high-level look at a hybrid solution combining outsourced coding and RCM automation to overcome these issues.
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