Critical Capabilities for Maximizing Revenue and Cashflow: Revenue Cycle Management Quality of Service and Value

PART 3: QUALITY OF SERVICE AND VALUE

Read Part 1, Part 2, and Part 4.

Laboratories and diagnostic organizations require several specific capabilities for operational and financial success. Selecting the right outsourced revenue cycle management (RCM) partner is one important step toward ensuring access to the comprehensive set of capabilities essential for:

• Maximizing revenue
• Increasing cash flow
• Reducing the cost of collecting reimbursements
• Decreasing average AR days

While selecting the right RCM outsourcing partner can profoundly impact your organization’s operational and financial performance, it’s critical to continually monitor and evaluate your RCM partner’s capabilities against industry data and benchmarks to ensure they continue to be the best partner for your unique goals.

At XiFin, we recommend using the following five criteria to frame this evaluation:

1. Innovation
2. Expertise and Excellence
3. Quality of Service and Value
4. Security, Compliance, and Trustworthiness
5. Reliability

To continue to support your operational and financial success, your outsourced RCM partner should consistently demonstrate these five core competencies. In this third post in a series, we focus on the specific capabilities related to Quality of Service and Value. If you missed either of the two prior posts, you can find them here:

PART 1: INNOVATION

PART 2: EXPERTISE AND EXCELLENCE

Quality of Service and Value Are Core Principles in All Successful Business Relationships

Quality and value are core tenets of any successful business relationship. Outsourced RCM partners must prioritize delivering products, technology, services, and experiences that consistently meet or exceed customer expectations. Quality speaks to the performance of the work itself, whereas value speaks to whether the customer perceives they are getting all the expected benefits in exchange for the cost of the service.

Establishing and maintaining high levels of quality and value in outsourced RCM business relationships is vital to an ongoing, collaborative partnership with meaningful and lasting outcomes. By prioritizing quality and value, RCM providers demonstrate long-term sustainability and a commitment to meeting the customer’s unique needs.

Quantifying Quality of Service and Value

One valuable tool laboratories and diagnostic organizations can use to help evaluate the essential capabilities for effective RCM is the Black Book Market Research annual report, “Diagnostic/Laboratory/Ancillary Services Revenue Cycle Management: Outsourced & Managed Support RCM Services User Survey.” Black Book Market Research conducts an annual, in-depth study on how diagnostic leaders evaluate outsourced RCM service providers across eighteen (18) key performance metrics. This report is based on the real-world experiences of over 2,600 survey respondents.

The XiFin team associates six of the 18 Black Book Research performance metrics with Quality of Service and Value.

1. CLIENT RELATIONSHIPS AND CULTURAL FIT (Question 4, page 13)

One of these metrics that can help you evaluate Quality of Service and Value is categorized by the Black Book Market Research team as “Client Relationships and Cultural Fit.” For this metric, the Black Book Market Research team asked study participants to evaluate RCM outsourced service providers on the following statements:

• Outsourcing vendor leadership honors customer relationships highly.
• The relationship with the vendor elevates the customer’s reputation.
• Improving healthcare delivery efficiency and effectiveness is a priority of the supplier.
• Governance of engagement is neither complex for buyers nor requires vendor management attention regularly.
• There is no regular transparency or quality issue.
• Culture clashes don’t threaten the relationship’s success or client’s satisfaction.

2. CUSTOMIZATION (Question 8, page 17)

In a second performance metric related to Quality of Service and Value, Black Book Market Research asked research participants to assess RCM outsourced service providers on the following statements pertaining to “Customization.”

• Outsourced services are customized to meet the unique needs of specific practices, client purposes, processes, and hospital/provider/physician models.
• Little resistance is encountered when changing performance measurements as clients’ needs vary.
• Extraordinary efforts are made to adapt and convert client special needs into workable solutions with efficient cost and time considerations.

3. TRAINING (Question 3, page 12)

Black Book Research classifies another performance metric related to Quality of Service and Value as “Training.” For this evaluation, Black Book Research asked study participants to evaluate RCM outsourced service providers on statements:

• Outsourcing vendor leadership provides significant and meaningful training opportunities for internal employees and client staff.
• Leadership strives to develop technology staff, client service, and customer servicing consultant employees.
• Training modules are effective and practical, so minimal post-implementation training is required on- or off-site.
• Regular updates are timely and require minimal additional training to implement.

4. DEPLOYMENT AND CONTRACT IMPLEMENTATION (Question 7, page 16)

The fourth performance metric in the Black Book Research study related to Quality of Service and Value asked study participants to evaluate RCM outsourced service providers on the following statements:

• Outsourcing services client deploys at a pace acceptable to the client.
• Services delivered eliminate excessive supervision over vendor implementations.
• Vendor overcomes client implementation obstacles and challenges effectively.
• Technical, organizational, and cultural implementation obstacles are handled professionally and punctually.
• The implementation time meets standard expectations.
• Implementations are efficient and sensitive to users’ specific situations, which may cause delays.

5. SCALABILITY, CLIENT ADAPTABILITY, FLEXIBLE PRICING (Question 10, page 19)

Next, the fifth performance metric covered in the Black Book Research study related to Quality of Service and Value asked participants to appraise RCM outsourced service providers on the statements below classified by Black Book as “Scalability, Client Adaptability, Flexible Pricing.”

• Outsourcing services vendor provides flexible pricing allowing the client to choose and pay for the precise functionality and services needed.
• Vendor invests in significant infrastructure and could provide services to enterprise organizations.
• Managed services meet the changing and varied needs of the outsourcing customer.
• Pricing is not rigid or shifting and meets the needs of the client.

6. SUPPORT AND CUSTOMER CARE (Question 17, page 26)

Finally, regarding rating RCM outsourced service providers on performance metrics related to Quality of Service and Value, the Black Book Market Research team asked study participants to evaluate providers on the following statements, which they categorized as “Support and Customer Care.”

• Account management provides an adequate amount of onsite administration and support to clients.
• There exists a formal account management program that meets client needs.
• Media and clients reference this vendor as an outsourcing services leader and top vendor.
• Customer services and relationship satisfaction are manifested through significant flagship clients as well as smaller and newest customers similarly.
• A vendor provides an appropriate number of accessible support and customer care personnel.

Outsourced RCM service providers that rank high for these six key performance metrics deliver the Quality of Service and Value that laboratories and diagnostic providers need to achieve their financial and operational goals. Objective industry data and benchmarks, such as the Black Book Market Research report, help laboratories and diagnostic providers quantitatively determine whether they have partnered with the outsourced RCM services provider that can deliver the capabilities needed to help them maximize cash flow, accelerate time to collection, and optimize return on cash.

The next post in this series focuses on the final two categories of core RCM services capabilities, “Security, Compliance, and Trustworthiness” and “Reliability.” Download the 2023 Black Book Market Research “Diagnostic/Laboratory Support and Revenue Cycle Management Outsourcing” report to see how your outsourced RCM service partner stacks up.

Download a free copy of the Black Book Report.

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