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Seamless Transition: Six Tips to Ensure Smooth Cash Flow When Switching RCM Providers

September 1, 2023

When healthcare organizations consider transitioning to a new revenue cycle management (RCM) provider, a primary concern is maintaining a steady cash flow during that transition process. Companies often recognize that their outdated or underperforming RCM systems and processes can lead to revenue loss and hinder communication with referring entities and patients. However, when it comes to actually making that change, the concern about cash fluctuations during their transition can give them pause and that’s completely understandable. That’s why it is important to choose an RCM solution provider who systematically takes concerns such as operational and financial stability, provider-patient relationships and investor confidence into account.

The good news is there is a proven pathway to implementing a new RCM solution smoothly–one that minimizes disruptions to cash flow. XiFin has successfully implemented RCM solutions and services for hundreds of healthcare organizations. Dozens of these implementations are for publicly traded companies, where investors pay close attention to any risks to cash flow. As a result, XiFin has created a comprehensive approach to protect and maintain a consistent cash flow during the transition to their platform.

Since implementing our first client in 2002, we continue to develop and refine our systems and processes to avoid cash flow disruption–and ensure our customers have the resources they need to achieve success quickly.

Based on XiFin’s deep financial expertise, six key considerations have been identified to help ensure a smooth transition between RCM providers:

1. Maximize historical collections

Transitioning to a new billing company can be a complex process. While it’s important for organizations to focus on setting their team up for success with the new system, it’s also imperative not to neglect the collection of accounts receivables (AR) with the previous vendor. Focusing on historical collections during the transition to a new billing company is vital to ensure that revenue is not left behind. XiFin collaborates closely with customers to develop a transition plan that includes the appropriate strategies and tactics to optimize cash flow during the transition period. While the XiFin team will not be managing the AR from the prior system, we are able to share strategies to help mitigate risks. For example, if there are concerns the previous outsourced billing company may cease working on older AR, we can help customers establish contingency plans and even recommend companies to assist with that collection process.

2. Conduct extensive pre-live claims testing

Before beginning the implementation, we conduct detailed financial benchmarking, which allows us to track expected collections from day one. We also develop and manage extensive pre-live claims testing to ensure the results received from the new system are in line with expectations from the start. XiFin employs a conservative pre-production testing schedule that effectively mimics historic production periods in current times. For instance, running a full month of data (e.g., generating out tests and actuals from a historic period, mimicking targeted client patient balances/payments from that historic period, etc.) reduces risk. Before going live, we test system configurations, ensure pricing information is correct, and test full path connections to payors. This approach demonstrates that the process is working as designed and allows for training on live claims.

We don’t leave things to chance, so there’s no scrambling to clean things up after going live. We confirm via the extensive pre-live claims testing that everything is working as expected beforehand.

3. Leverage specialized resources for system configuration

During implementation, XiFin deploys a specialized, dedicated team that focuses on system configuration by service and payor plan. Even in the most complex customer environments, we work through a customer’s specific pricing, service menu, clients, and payors to optimize workflow right from the start. We also employ payor experts who focus on ERA/EFT enrollment, know which payors allow electronic submissions and understand the difference in payors as far as timing for a transition. This ensures electronic submissions are maximized from the start.

4. Load expected reimbursement rates by payor

Visibility is key to maintaining steady cash flow during the RCM transition process. That’s why we load expected reimbursement rates established through a contract or historical behavior during implementation into the billing system. This allows tracking of actual vs. expected reimbursement rates in real-time, which helps identify underpayments and enables close monitoring of cash flow. Loading expected reimbursement rates by payor establishes visibility, enables more accurate forecasting of reimbursement, and allows both XiFin and the healthcare organization to monitor payments and confirm that they are getting paid as anticipated.

5. Utilize advanced reporting and track key metrics

Real-time reporting is critical to maintaining steady cash flow during the RCM transition process. Unlike many other billing companies, XiFin provides detailed, real-time visibility into the RCM process. XiFin customers don’t have to wait until the end of the month to see what’s happening and whether key metrics–such as collections, write-offs, and outstanding AR–match expectations. Regardless of whether customers manage their own RCM process using XiFin RPM or outsource their RCM to XiFin, they have full visibility into the system and performance at all times.

6. Leverage collective intelligence–applying lessons learned and analytics

XiFin applies the collective intelligence and lessons learned from all implementations to ensure cash flow is maintained during the RCM transition process. We use analytics and XiFin-recommended best practices from our experience across our entire customer base to determine what works best while still allowing for configuration based on a specific business’s nuances. This approach allows us to provide our customers with the most effective processes, even when there is little historical data available from a new customer.

When selecting a new RCM partner, it’s crucial to inquire extensively about their implementation plan, their experience with large/complex/publicly held entities, and the caliber of their implementation resources. Asking the right questions can provide valuable insights into their process and ensure a smoother transition. The right questions yield insight into their experience level, not only guaranteeing a smoother transition but also ensuring you choose a partner that is up for the task at hand and the relationship moving forward.

Contact us to learn more about XiFin’s implementation plan or questions to consider when evaluating a new RCM partner.



Additional Reading:

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Keys to Increasing Cash Flow: 5 Things to Consider When Choosing an RCM Partner

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