Factors for Successful Offshoring of Revenue Cycle Management Services

Those considering offshoring their RCM may have questions about setting their teams up for success. The right partner will ease any concerns and instill confidence in your team by leveraging commonly used project management tools and engaging in open, honest communication.

When considering the life cycle of the engagement, here are some best practices you should watch for. Once you’ve decided to outsource rcm services, you and your outsourcing partner should work together to:

• Clearly Define the Scope of Work in the RFP: Defining the scope of work helps to eliminate any ambiguity. For example, with A/R, what range would the RCM team work? When considering the services you expect from your RCM partner, what's in scope? Who is responsible on the customer and vendor sides? This is also a great time to define volumes so both teams can staff appropriately.
• Define and Document RCM Partner Capabilities: During contracting discussions, it is essential to fully assess and document the capabilities of your selected RCM vendor. If this step is overlooked, it can lead to confusion and disruptions down the road.
• Be Transparent About Cultural Differences: You must understand cultural differences and what to expect. For example, in India, people are generally taught from childhood to respect and be agreeable to their elders despite differences in opinion. This can translate to a need for more comfort with questioning or pushing back. In the U.S., people are commonly taught from a young age to question things. We are empowered to ‘do things in new ways.’ When selecting a partner with an offshore team, it’s important to familiarize yourself with cultural differences.
  
  At AGS Health, project managers based in India receive additional training on cultural differences. They are encouraged to ask questions and offer guidance to customers. AGS is committed to creating a more consultative team so customers can understand what systems, processes, etc., are working for other healthcare organizations. And they have a team that is empowered to engage in and guide those discussions.
• Customer-Side Support Must Be Present: RCM is complex, and with each healthcare organization doing its RCM differently, it isn’t a ‘lift and shift’ operation. Teams on both sides must support the transition and be actively engaged throughout the project – especially during the first 18 months when processes and systems are being established.
• Clearly Define Success Factors: What does success look like? Are these factors shared with all the appropriate team members? Aligning on success not only unites team members but also gets them working toward a shared goal and helps to keep them on track.
• Set Clear Expectations for Measurement: It’s hard to measure progress when the teams are clear about the metrics (from the customer and vendor sides). To determine metrics, it’s important to review historical performance when setting targets.  This not only helps to ensure goals are realistic, but it aligns team members from both companies.
• Define Productivity Expectations: Using historical performance data and feedback from the RCM Vendor, what are realistic expectations for productivity? Productivity expectations must be documented and provided in a shared location where all teams can access the information.
• Understanding Gaps: One element of risk mitigation involves understanding gaps. For example, cracks can occur when there are cultural differences or when the next steps aren’t clearly defined at the close of a meeting. How many times have you been in a forum when everyone walks away with a different understanding of what transpired? To control these gaps, it’s helpful to have detailed documentation, including meeting notes that are shared and signed off on by both organizations. Again, the goal is to ensure that all team members are aligned.
• During the Transition, Perform a Soft Launch: It’s essential that RCM outsourcing isn’t viewed as a ‘lift and shift’ project. Teams from both organizations need to be involved, motivated, and participating. For the first few weeks, your team needs to review the RCM partner’s work to ensure it meets your expectations. Your team members must make time for this critical step. Auditing the work for the first few weeks allows you to provide feedback and allows your vendor to make adjustments. RCM workflows are very different from organization to organization, so this is an excellent opportunity for the teams to get the project off to a great start.
• Quality: You and your RCM Vendor need a clear and documented understanding of how quality will be scored and measured, as well as the frequency of quality reviews. Quality delivery is critical. This will help to ensure the teams have a shared view and understanding.

Collaboration is Critical

While all the above are essential for successful offshoring, other activities are equally important. These activities require both teams to work together and have open and honest dialogue.

Process documentation to capture customer workflows and how the customer's revenue cycle works is essential. Documenting Standard Operating Procedures (commonly known as SOPs) also helps to ensure full transparency for all involved. If these documents aren’t readily available, you and your vendor will need to work together to build these documents and have them approved by both parties before work begins. These types of records help ensure that, from an operational perspective, both teams are fully informed.