Cash flow can be complicated in any industry, but insurance and billing make it especially complex in healthcare organizations. Revenue cycle management (RCM) solutions come in several forms, and they may use many different technologies to help providers optimize revenue cycles. From streamlining insurance reimbursements to improving payment rates, RCM solutions — including expert-led outsourced services — can support healthcare practices at every step of the process.

While an RCM solution is a great way to invest in healthcare IT, the system must meet your organization’s unique needs. Before shopping for an RCM solution, take some time to understand your options and how to find the right service for your team and patients.

What Can a Healthcare Revenue Cycle Solution Do?

RCM systems offer resources at all stages of the healthcare revenue cycle, from the patient’s first interaction with the practice to collecting the last payment for services. Some work as standalone systems, but others work alongside your electronic health record (EHR) with seamless integrations. Ultimately, these systems help boost revenue while offering other benefits like improved customer engagement and productivity.

Some of the features you might find in an RCM solution include:

• Pre-visit tools, like insurance eligibility verification and prepayment options.
• Patient payment portals and processing resources, such as options to pay via text. 
• Data analytics and engagement insights.
• Patient support through real-time chats or experienced agents.

What to Consider When Choosing a Revenue Cycle Solution

As you look for an RCM solution, identify your biggest challenges and goals. Then, consider what you need in the following areas before investing in healthcare IT.

1. Technology and Platform

The technology used in an RCM solution can vary widely, and each practice has different needs. Consider what you might need for the following technology topics and how a given RCM solution can meet those requirements:

• Deployment speed: Slow integration processes can come with downtime and business interruptions. Ask yourself how much time you’re willing to spend on implementation.
• EHR integration: Connecting an RCM tool with your EHR can greatly improve your processes and reduce administrative burden, so check for compatibility with your EHR. Look for an EHR-agnostic system that can accommodate any of these platforms and adapt to a new one if you ever change EHRs in the future.
• Flexible access: Will your team need to access software from different devices, like desktop computers and tablets? What about patients? See if they can access the system from phones, web browsers, in-office kiosks and other channels.
• Supported payments and processing methods: Similarly, will your patients have flexible payment options? Look for mobile pay, text-to-pay support, saved cards and other methods to make paying as easy as possible.
• Updates: Will the platform receive regular updates for technical demands, security patches and other changes? These aspects are crucial in a highly regulated industry.

2. Customer Service and Support

Make sure your revenue cycle solution has an excellent team supporting it. If you have technical issues, will you be able to talk to a knowledgeable person? Who will patients talk to if they have questions? Ideally, your provider will have a support team based in the United States with a thorough understanding of the nation’s unique insurance system.

Another customer service element to review is the provider’s reputation. Check for positive reviews online and ask about performance metrics. Millennia, for instance, enables a 98% patient satisfaction rate and helps providers recover two to four times the national average in patient payments.

3. Technology to Automate

Consider what tasks or technologies you want to automate. Dive into your processes, and look for opportunities for automation, but remember to leverage your existing software. Your EHR does a lot, but it wasn’t designed for non-clinical tasks like patient payments and insurance eligibility verification. By pairing your EHR with purpose-built software, you can fill the gaps for a comprehensive, end-to-end RCM solution.

While some EHRs or standalone platforms offer basic RCM tools, a system designed for RCM can more effectively use data from your EHR. Aim to automate or provide self-service tools for tasks like taking payments, sending reminders and collecting forms.

4. Data to Analyze

You might have mountains of data at your disposal, but can you use it well? Identify data points you may want to learn from and opt for an RCM system that simplifies collecting and analyzing the information. Consider areas such as payment data, customer preferences and customer satisfaction.

Then, see if your RCM system can make this information actionable — can it help you improve your revenue cycle by making sense of the information? Here are a few features to assess:

• Monitoring tools: Look for built-in data collection, such as monitoring tools that assess patient interactions. For instance, Millennia’s Speech AI tool listens to phone calls and monitors them for quality assurance and patient satisfaction. Monitoring payment data can also provide insights into trends about your patients.
• Tailored patient engagement: An RCM solution can analyze interactions with each patient to identify the best ways to communicate with them to improve their likelihood of paying. Perhaps one patient typically responds well to a payment reminder via a text during the day, but another patient gets annoyed with these because they occur while the patient is at work. A smart RCM platform can use these insights to send reminders when they’re most effective.

5. Security

No healthcare technology solution would be complete without strong security. Ask about how an RCM solutions provider will handle your data. Do they maintain separation between clinical and non-clinical data? While EHR integration is highly beneficial, the access to sensitive information should be limited, with your team or vendor teams accessing only relevant details when offering support to you or a patient.

Another important element to consider is where data is stored. An RCM system that stores data in the U.S. greatly simplifies compliance with HIPAA and other regulations. A domestic team can better understand the unique IT landscape this data requires.

Naturally, your RCM must also comply with HIPAA in other technical aspects to safeguard any protected health information. Compliance with the Payment Card Industry Data Security Standard is vital for RCM systems, too.

Should You Outsource Your RCM Strategy or Do It Yourself?

Outsourcing is common and on the rise in healthcare, with the best results often coming from non-clinical areas where an organization lacks expertise. While in-house RCM functions can offer more control, it can significantly increase costs and burden your IT team, and it may fall short of the results a specialized service provider could achieve.

By outsourcing your RCM technology and services, you get access to the knowledge and resources of a company that’s dedicated fully to the revenue cycle. You offset extensive staffing demands and allow your highly qualified team to focus on clinical work or higher priority initiatives. Working with a healthcare-focused, U.S.-based company can help address common concerns with outsourcing and align these services with your organization’s needs.

Contact Millennia for Effective Revenue Cycle Management

If you need to upgrade your RCM strategy, Millennia can help. Our end-to-end healthcare revenue cycle solution was designed for this unique industry, with powerful tools for building a better patient payment experience and maximizing revenue.

Request your consultation today to learn more about how Millennia can help.

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