Webinar: Building and Scaling a Revenue Cycle Management (RCM) Function

Top takeaways from the webinar

🏃 Getting started with fee-for-service (FFS) RCM‍

Start with the pieces that will enable you to see patients quickly - 1) which insurance plans you’re in-network with (contracting), and 2) which patients are covered by insurance (patient intake and eligibility). Get this going and you can then work your way through the rest of the process.

🤝 Day 1 resourcing

Instead of fully outsourcing your RCM, consider exploring a hybrid arrangement where certain components are maintained in-house for more visibility and control over the process (e.g. cash posting, or patient invoicing & collections).

💻 Day 1 tech stack

Our panelists preferred best-in-breed solutions to native practice management capabilities in your EHR. Key initial pieces to look for are: 1) insurance contract management, 2) real-time eligibility verification, and 3) patient registration and intake.

📈 Scaling RCM

Reference industry benchmarks and KPIs (e.g. from HFMA, MGMA, or NAHAM) to ensure your RCM function is operating efficiently as you scale.

↳ Intake and Eligibility

A 2022 study across over 440 million claims showed that front-end revenue cycle issues cause 41% of all payment denials. Look to invest in solutions that support real-time eligibility and minimize data entry errors to avoid preventable denials.

💳 Patient Collections

3 best practices to maximize patient collections: (1) provide price transparency to prevent surprises for patients down the line, (2) incorporate financial assistance options into the bill pay experience, and (3) enable multiple payment alternatives (from Apple Pay to mail-in checks).

🙅‍♀️ Denial Management

Look for technology solutions that enable you to efficiently draw insights from your rejections and denials. This allows you to implement fixes upstream in your RCM process and prevent avoidable denials.

Explore RCM reviews

Whether you’re in the market for an RCM solution, think you may be soon, or are just interested in better understanding how provider organizations work with vendors in the space, check out our RCM in-depth reviews.