Dispelling myths about revenue cycle partnerships


In this article, LuAnne Anderson explores the challenges physician practices face in managing their revenue cycle in-house and debunks 4 common misconceptions of using an external partner to manage the revenue cycle. She highlights the benefits of partnering with an experienced vendor, which include:

  • Access to infrastructure
  • Expertise
  • Support for improving revenue generation and streamlining operations

By: LuAnne Anderson, Vice President Ambulatory Client Management, Optum

Physician practices face a multitude of obstacles when it comes to managing their revenue cycle in-house. In recent years, the shortage of skilled resources has made it increasingly difficult to find and retain talent, a problem made worse by the COVID-19 pandemic. Remote work has led to high demand and competitive wages, resulting in frequent employee turnover and instability for practices. Practices struggle to compete and lack the resources needed for efficient revenue cycle management, leading to delays in claims processing and reimbursements.

Beyond labor challenges, other factors contribute to the difficulties faced by physician practices. The lack of infrastructure hinders optimal cash flow. Securing capable leaders who can drive success and ensure the overall health of the health care system is a struggle that further compounds the challenge. Limited knowledge and understanding of revenue cycle requirements leave practices lagging behind and unable to identify areas for improvement. Time constraints and competing priorities further impede progress.

To address these challenges, practices can select a partner to manage their revenue cycle. This approach provides the necessary infrastructure, expertise and support to optimize revenue cycle management. By collaborating with a trusted RCM partner, practices can overcome these obstacles and establish a more efficient and successful revenue cycle management system.

Why do some groups choose to keep their RCM in-house?

Navigating community perception

A local community’s negative perception toward using externally managed services is a legitimate concern for practices. It may be seen as neglecting responsibility to provide local jobs. While remote work has somewhat alleviated this worry, it remains an important consideration for decision-makers. Consequently, some physician practices opt to keep their revenue cycle management in-house to avoid potential negative perceptions.

However, for those who wish to explore working with an external partner while addressing community concerns, physician practices should carefully select an RCM vendor that establishes itself as a trusted partner. These vendors operate as an extension of the practice, adhering to policies and procedures while prioritizing patient care. By prioritizing the patient experience and partnering with a vendor committed to the practice's values, physician practices can successfully navigate community concerns and maintain a positive experience.

Negative past experiences

Physician practices may also hesitate to have an external partner manage their revenue cycle due to negative past experiences with vendors. Practices may have faced the challenge of working with stagnant revenue cycle partners who fail to update their processes to meet changing business and industry needs. Or, they may have experienced outdated follow-up methods that were effective decades ago but no longer work in today's landscape. However, it is important for practice leaders to reconsider their stance, as better options are available.

It is essential for practices to seek out a vendor that can grow alongside their organization, continuously updating strategies to align with industry changes. Prioritize a partner with compliance experts and transparent communication.

Physician practices should not let past negative experiences deter them from partnering with a managed services vendor. The right RCM partner listens, adapts, communicates and strategizes alongside the practice, which can revitalize revenue cycle management.

Myths about managed services

I frequently encounter 4 persistent myths that discourage practices from considering working with a managed services partner for RCM.  It's time to debunk these myths and shed light on the benefits of working with an experienced RCM partner. Let's explore these misconceptions and present compelling reasons to reconsider outsourcing your revenue cycle.

Myth 1: A vendor won't work as hard as we would

One of the most prevalent myths is the fear that vendors won't work as diligently for the practice and may cherry-pick lucrative accounts. This myth suggests that using an external partner diminishes the dedication and effort put into managing the revenue cycle. However, a reputable RCM vendor is committed to the success of their clients. They have the expertise, resources and motivation to work diligently and optimize revenue collection on behalf of the practice.

It's crucial for physician practices to understand that these concerns can be eliminated by selecting the right partner through a thorough vetting process. To choose a diligent vendor, prioritize comprehensive reporting and proactive communication. These reports allow you to quickly identify any overlooked issues and ensure that the necessary data supports the vendor's actions. A true partner will proactively provide monthly financial performance reviews and supply supporting documentation for their assessments.

Ask about their approach to resolving issues and their commitment to collaboration. Inquire about their approach if a metric falls behind and how they would address potential problem areas within the AR. Understanding their strategies for identifying and resolving issues will help you identify vendors that are committed to working collaboratively and transparently with your practice.

By choosing the right partner and asking pertinent questions, physician practices can find vendors dedicated to their success and committed to fair and comprehensive revenue management.

Myth #2: It’s more expensive than keeping RCM in-house

Another common myth is that it’s more expensive than keeping it in-house. Contrary to this belief, working with a managed services partner can be a cost-effective solution. By partnering with an experienced RCM vendor, practices can benefit from economies of scale, streamlined processes and access to advanced technology. These factors often result in improved revenue generation and reduced costs compared to maintaining an in-house RCM team.

When evaluating in-house resources, consider comprehensive expenses like salaries, benefits, equipment, office space, utilities, HR support and IT resources. Underestimating the true cost of managing RCM internally can be costly. Working with a trusted partner provides access to a larger pool of resources, allowing practices to focus on patient care and support clinical staff.

Experienced vendors like Optum understand the value of time and efficiency in RCM services. With almost 50 years of expertise, we optimize productivity through extensive industry knowledge. Partnering with an established RCM services vendor brings significant value to physician practices, combining experience, efficient workflows and continuous improvement efforts for expedited cash flow and enhanced productivity. When considering an RCM services partner, prioritize experience, efficiency and ongoing improvement.

Taking a comprehensive view of costs and considering the potential return on investment will lead to a more strategic and beneficial partnership with an RCM services vendor.

Myth 3: A vendor cannot scale with my practice

The concern about scalability when partnering with an RCM services provider is a common myth. However, a reliable RCM partner understands the importance of scalability and has the flexibility and resources to adapt to changing needs and expanding operations. A strong partnership ensures that the partner can grow alongside the practice, providing seamless support throughout the journey.

As an experienced revenue cycle partner, Optum has proven its ability to scale alongside their customers' growth. For physician groups expanding regionally or nationally, or aggregating practices, it's crucial to seek a partnership rather than just a vendorship. A reputable revenue cycle company strategically plans for both the present and the future, engaging in ongoing conversations about your organization's growth plans. By proactively scaling their resources to meet your evolving needs, a reliable RCM partner ensures alignment with your strategic goals and provides the necessary support for long-term growth.

You can establish a true business partnership with an RCM services vendor that goes beyond transactional services and includes growth-oriented discussions. This ensures that your growth strategy is seamlessly integrated into a collaborative partnership.

Myth 4: Going external means giving up control

This myth suggests that working with an external partner relinquishes control, which can be a concern for revenue cycle leadership in physician practices that have never done it before. They may struggle to understand how partnering in this model can work and fear losing decision-making power. However, a reputable RCM partner operates as an extension of the practice's team, ensuring the practice maintains control.  

To address this concern, it's crucial to find the right partner who truly understands your practice's needs. Look for a partner that not only believes in becoming an extension of your business office but also demonstrates a commitment to adapting to your policies and procedures while enhancing them with their best practices. Seek out a partner that values close collaboration, aligning with your practice's goals, strategies and policies. With this approach, the practice retains control while benefiting from the partner’s expertise, technology and industry insights.

When selecting a partner, effective communication and joint decision-making are key. It's important to work with a partner who treats it as a true collaboration, regularly engaging in touchpoint calls, exchanging information and making decisions together. By maintaining this level of communication and involvement in the revenue cycle, you can ensure that you remain in control while your partner seamlessly operates as an extension of your company.

Physician practices can confidently embrace partnerships that aim to improve the revenue cycle. RCM partners can help practices overcome infrastructure and resource challenges, ultimately unlocking the full potential of the revenue cycle.

Unlocking the benefits: How it works for you

Now that we have debunked the myths surrounding working with a partner to manage the revenue cycle, let’s explore how it can work for you. To help you in your consideration, let's address 3 important questions:

  1. Do you have the resources to successfully manage your revenue cycle in-house?
  2. Do you have the infrastructure to thoroughly analyze your revenue cycle team and identify any inefficiencies?
  3. Where do you want to invest your time?

If you cannot confidently answer the first 2 questions with a resounding "yes," then partnering with a managed services partner to manage your revenue cycle is worth considering. Additionally, take a moment to reflect on your answer to the third question.

To effectively manage your revenue cycle in-house, you need infrastructure and dedicated resources. An RCM services partner provides access to their expertise, infrastructure and skilled professionals, allowing you to focus on patient care and growth.

An RCM services partner can assist if you lack the required infrastructure. They bridge the gap in under-resourced practices and work as an extension of your group, improving collections, expediting claim resolutions and ensuring accurate patient billing. They offer guidance to enhance revenue cycle performance and ensure transparency in processes and outcomes. By leveraging the expertise and support of an RCM services partner, you can overcome infrastructure challenges, optimize revenue cycle performance and drive success for your practice.

In conclusion, challenge misconceptions and explore the benefits of working with an experienced partner to manage your revenue cycle. This model provides many advantages. Partnering with a trusted RCM vendor fosters growth, efficiency and improved financial outcomes. Unlock the potential for enhanced revenue generation, streamlined operations and a fruitful partnership that supports your practice's growth and success.

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LuAnne Anderson is a highly experienced professional with over 30 years of expertise in health care, specifically in revenue cycle management, practice management billing software and physician practices. As the leader of the Enterprise Account Management West team at Optum, LuAnne is dedicated to developing long-term partnerships with customers, ensuring their success and satisfaction. Throughout her career, LuAnne has held various leadership roles in patient accounts, large multispecialty practices, information technology, process improvement and product support. Her extensive background in these areas has equipped her with a deep understanding of the complexities and challenges in health care. 

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