Revenue Cycle Management: How to Get Started (Part 1)

  • Lee Ann Nichols

You’ve done your research and you’re convinced that implementing a new revenue cycle management (RCM) system will deliver real value for your organization. Where do you go from here? Every organization is different, but undoubtedly you will need to establish executive buy-in. Here are the key steps to take to help you get your team on board:

  1. Understand and engage the decision maker(s)

Typically, in addition to the lab administrator or director of reimbursement, there are three other groups involved in making decisions about the procurement of new technology solutions: IT, Finance, and the executive in charge of the lab. You’ll want to bring all of them into the project as early as possible.

  1. Understand and be able to articulate the need or motivation to make a change

Your executive team is going to expect that you can clearly articulate why a revenue cycle management system is required. What problems does it solve? What opportunities does it open up? For your organization, maybe the need is increasing cash flow. Maybe it’s about reducing denials or ensuring compliance with payor and regulatory requirements. Whatever the motivation, be prepared to talk about it in the relevant terms for your organization. For example, if your CFO is strongly focused on return on investment, be prepared to dive into a discussion on ROI. If your executive team is more oriented around top-line revenue growth, frame the discussion in that context.

  1.  Arm yourself with the right information

Preparing yourself with the right information and being ready to handle the tough questions is the best way to get your team on board. Be sure you are ready to cover questions of a wide variety of topics – not only value and cost. You may get questions on technology, delivery model (e.g. SaaS vs. ASP), or visibility into key performance metrics. It may also be important to be able to articulate the risks of deferring the investment. If your organization is required to submit data under the Protecting Access to Medicare Act (PAMA) of 2014, make sure you understand both the requirements and your readiness for the next data collection period.

  1. Understand the impact of a change

In addition to understanding the need to be filled or opportunity to be leveraged and what value the system will bring, you also need to deeply understand and be able to express the impact that the change will have on the organization. For example, if you choose an outsourced revenue cycle management model, there are likely to be staffing and resource implications. How would the team be affected? How would it impact patient and physician engagement? Will other processes need to be modified?

  1. Understand contracts with current providers

Revenue cycle management is a complex and critical business process. Most organizations aren’t comfortable turning off one system the same day they turn on a new one. You’ll need to understand the wind-down process with any existing technology vendors and understand the expectations and logistics of transitioning from one system to another.

Now that you have some tools in your toolbelt for getting your executives on board with the value of adding a new RCM system, stay tuned for an upcoming post on the capabilities you should look for in your next RCM system.

To get the tools you need to influence your team to implement a new RCM solution, click here.

Published by XIFIN
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