Revenue Cycle Management: Partner vs. Vendor, Is there a difference?
There are many vendors that offer revenue cycle management products and services, but would all of those companies make good business partners? Let's be clear. Organizations offering revenue cycle services largely fall into two categories, revenue cycle management vendors and revenue cycle management partners. There are differences between the two and they are fairly easy to identify. But many revenue cycle management managers and financial officers may not be fully aware of how to spot them.
A vendor will provide a product or service for a fee. You may rarely see them or hear from them unless a bill is due or they're trying to sell you a new service or product. On the other hand, a partner is interested in your entire company, not just the area of service they are providing. A partner is interested in knowing your mission and how you present yourself to the patients that you serve. For lack of a better term, a partner seeks to become a truly integrated member of your team, participating in regular meetings and seeking to better understand how changes to the revenue cycle may impact other aspects of your business.
Outside of the obvious signs that a vendor may not be a suitable business partner for your organization, here are three additional things to consider.
- Track Record
A vendor may not care to know why your organization does not utilize a hard collection process, where a partner values that decision and will offer suggestions and recommendations for handling unresolved balances by making the effort to understand your patient population, policies, and procedures.
A vendor may want to shortcut and bypass the critical importance of knowing your culture and just focus on revenue. While that may seem really good at the onset of an agreement, generating immediate needed cash, what happens six or nine months later when a policy change impacts the billing process for a provider treating a Medicaid patient and your vendor has not taken the time to fully understand your mission for patient care? A disruption to the vendor process most likely would occur; impacting revenue streams negatively.
The goal of a partner is to develop a long-term relationship by seeking to understand your organization's entire circle of life, not just the revenue pipeline. Since revenue cycle services today include answering statement calls from your patients; understanding your culture is extremely important to avoid patient confusion. Your revenue cycle partner should speak to and act as an extension of your internal staff, contributing knowledge, expertise and resources as needed. A partner should insist upon being part of any culture competency training to clearly understand the real mission in terms of patients, care, community and outreach.
Being transparent when handling your revenue should be the assumption right? This is where a partner would define and lay out all expectations at the beginning of a contract and follow through for the life of the agreement. Expert partners know their job is not as easy as simply documenting what is occurring on a claim and filing it, but that there are many steps before, during and after that to ensure success.
Transparency comes in many forms, from providing access to reports and dashboards, providing key performance indicators (KPI), to collaborating on the priority of payers and different lines of business.
Some vendors may pick from the low hanging fruit first to quickly generate results but lack the ability to provide enough detail to support a lag in payments or be able to document why account receivables are increasing. However, a valued partner knows what it takes to work with your team in designing a comprehensive revenue cycle approach, unique to your practice, providing proof that all claims, even the most difficult, are worked and accounted for as they progress through the entire cycle.
Finding a partner to handle the revenue pipeline can be compared to shopping at the big box stores vs. shopping at the local business down the street. Sure, the big box store has 25 options of a single product and may be slightly cheaper, but are they there with the step ladder you need to access product from the top shelf? The business owner that insists on knowing their customers on a deeper level sees the value in providing those extra touches, such as "step ladder" customer service.
Consumers now look for customer service with a 5-star rating. Having a proven track record in a single industry vs multiple service lines means that a partner is able to focus on the small nuances, details and customer service needs of your specific organization, while the vendor focuses solely on mass sales.
For vendors to succeed, their offerings are often developed to be "one-size fits all" solutions, designed to increase their profits with zero financial risk to themselves once the sale is completed. And it should come as no surprise that they promise the moon but deliver a solution that may not be a good fit for your specific circumstances and needs. This may force your organization at minimum to make compromises or add other services to fill those gaps. Are you willing to cut corners? Are you willing to leave money on the table due to unresolved claims? Are you willing to cut back on quality care for your patients because your revenue is declining due to poorly planned strategies and procedures?
A valued partner will be in the trenches with you, standing alongside as a friend, helping you make the best decisions and choices for your organization. They will have the expertise you need when you need it. Their success is linked to yours.
If based on the information presented above you find that your healthcare organization's Revenue Cycle vendor hasn't provided the level of support or expertise needed, or was simply not available when problems arose, now is the best time to consider your options. Seek out a Revenue Cycle partner who will be in your corner, just like a friend, every step of the way, knowing they have your best interest in mind.