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Thinking of Changing RCM Solutions? Read This First…

Authored by: Phallynn Espinoza

Staff overload and dissatisfaction with your existing RCM vendor are common reasons to shop for an alternative. However, I notice many practices don’t start the shopping process soon enough, which can create challenges and unnecessary stress.  

 

That’s why I always tell practices that the moment they think they’re interested in changing from their current RCM service provider, it’s time to start shopping. After all, even if they decide not to make a switch down the road, there’s nothing lost by starting early.  

 

Not sure where to start? Here are a few pointers to get you on the right track.  

Fast setups are possible but not ideal 

I often speak with practices that need to make a switch fast. Maybe there’s an issue with internal staffing or they’re not happy with their existing vendor and their contract expires soon.  

 

Regardless, having more time to make the switch is always better than having less time. A great RCM partner can get you set up quickly, but if your contract expires in a week and you’re hoping to be fully functional by then, it’s not enough time to complete the entire setup properly.  

 

You’ll also need adequate time to provide the vendor with the details required to understand your needs and get an accurate quote. And that starts with knowing your numbers so there are no surprises later. (I shared my favorite questions to ask during the shopping process so you don’t get hit with hidden expenses or “buyer’s remorse.”) 

Bring potential vendors your numbers  

Providing a potential RCM vendor with important information upfront helps them give you accurate pricing, understand your needs, and set realistic expectations for getting up and running. Without this information, it can be like navigating in the dark, with risk of delays. Here are a few things to provide.  

 

The amount you have in outstanding accounts receivable  

Your annual collection amount 

Your average number of visits  

Number of providers 

 

With these numbers, an RCM healthcare vendor can understand how much revenue you’re collecting and identify any opportunities for improvement.  

 

For example, if you’re collecting $90 on average per visit but should be collecting $120, you might have some back-end work that needs to be done. In other words, you might need your partner to rework some claims to recapture some of that lost revenue. (This, by the way, is a great exercise to do, because I see practices lose far too much revenue because they are not fully capturing it.) Having this information upfront is important as it impacts both your total cost and the ability to set your service up correctly.  

Understand RCM medical interface needs  

As you make a switch, you’ll likely need to interface with other software and technologies. The challenge is that if these products sell competing RCM products and services, they might not make the interfacing process fast and easy.

  

In most cases, a solution provider is legally required to allow interfacing with competitive solutions and is also typically contractually bound to do so. As a result, define your needs upfront (a great vendor can help with this) and get started quickly to avoid any potential delays.  

What to do next?   

Start shopping. Again, even if you aren’t sure whether you’ll make a switch, the time to start is early. When you have months or weeks instead of days to transition to a new RCM solution, you’ll be better positioned for success because you’ll have time to work out any challenges that come up without being up against a fast-approaching renewal date.  

 

And if you’re shopping RCM solutions and need some guidance, our experts can help you get started.   

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