Throughout the pandemic, businesses in all industries have struggled with staffing and those challenges continue. With the surge of variants growing, there is continued uncertainty around when the pandemic will finally end. That means staffing will continue to be a challenge for some time to come. For revenue cycle processes, staffing challenges can lead to further revenue cycle degradation—something health systems and physician practices cannot afford.
7.7 million workers and their 6.9 million dependents have lost employer-sponsored insurance and medical debt during the pandemic grew to $47 billion.[1],[2] It’s no surprise that 84% of healthcare leaders say COVID has caused issues with cash collections.[3]
How can health systems and physician practices address revenue cycle staffing challenges now to mitigate the ongoing impact on revenues? Outsourcing all or a portion of the revenue cycle staff can help. Outsourcers can add value and increase productivity of an organization’s existing team, especially if that team was reduced during the pandemic.
When choosing an outsourcer, many organizations overlook a critically important element: The qualifications and competency of the members of the outsource team and how that vendor sources, identifies, and develops top talent. You need to know their process for ensuring the highest quality team members. After all, these individuals are going to interact with your patients. They’ll adopt your brand and become the face of your organization.
Following are four questions to ask that can help you choose an outsourcer with the highest quality talent.
Do they go beyond traditional recruiting and screening practices?
The tradition approach to recruiting—reviewing resumes, checking employment history, and talking with references—don’t go far enough. Look for an outsourcer who incorporates the appropriate evaluation, testing and screening practices that most accurately identify candidate past job performance and future potential.
And let’s not forget the importance of thorough background checks. To fill job vacancies quickly, many organizations blindly trust information that the candidate has supplied on a resume or job application and don’t perform background checks. In fact, quality background checks can be completed fairly quickly and at limited expense, and provide vital information about candidate character and qualifications that you cannot uncover through the standard interview process.
Do the outsourcer’s team members meet your specific needs?
Every organization’s needs are different. If a large portion of your patient population is Medicaid or Medicare patients, you’ll want to choose a vendor whose team members have expertise in those areas. In general, individuals who work with payers need tact, patience, and perseverance. They need to understand each payer’s specific requirements to reduce timely filing issues and delays in reimbursement. They also need to understand the importance of coding accuracy in order to avoid rejections, denials, and write-offs.
Likewise, self-pay vendors need team members who are trained in the softer skills, like compassionate communications, active listening, and empathy. They need to understand that they are acting as an extension of your own team and that they have an impact on your brand reputation. Even a single negative patient financial experience can completely negate a positive clinical experience.
It is also essential that the vendor’s team members have a solid understanding of revenue cycle systems. They need to know how each system integrates within the revenue cycle and how their particular role impacts the success of the entire process.
What is their approach to education and development?
Most health systems and physician practices understand the value of education and continuous improvement in building and maintaining high-quality revenue cycle experts. It’s important to ensure the outsourcer you choose has the same understanding.
You should also ask if they require any professional or industry certifications for their revenue cycle team members. One of the best is from AAHAM (American Association of Healthcare Administrative Management). Look for an outsourcer that values certification to the point that they sponsor their team members certification. These types of vendors understand that the educational pursuit of industry certifications bring value to the client, the associate, and the vendor themselves.
Do they display a strong focus on quality improvement?
It’s important that each of the vendor’s team members is given clearly defined goals and deliverables that they’re expected to achieve, which should include specific, measurable outcomes. It’s not enough just to say they need to provide a positive customer interaction. This is one of the best ways to ensure accountability and that each team member takes ownership of the patient financial experience. Remember, the quality of your vendor’s revenue cycle teams impacts your accounts receivable, cash flow, patient relationships, brand reputation, and your bottom line.
The path forward
Each and every revenue cycle team member—your own or your vendor’s—plays a critical role in your organization’s long-term financial viability. In these challenging times, health systems and physician organizations simply cannot settle for anything less than optimally performing revenue cycle. Asking the right questions is a great place to start.
[1] https://www.commonwealthfund.org/publications/issue-briefs/2020/oct/how-many-lost-jobs-employer-coverage-pandemic
[2] https://www.cbsnews.com/news/pandemic-medical-debt-overdue-debt-collectors/
[3] https://go.beckershospitalreview.com/key-2020-trends-to-improve-patient-collections-pre-and-post-service