Choosing the right revenue cycle management (RCM) company is crucial for healthcare providers aiming to optimize their financial processes and ensure a smooth revenue flow. To make an informed decision, here are 20 important questions you should ask when evaluating potential RCM companies: 

1. What is your experience in healthcare RCM?

Determine the partner’s depth of experience in your industry to ensure they understand the complexities and nuances of medical billing and coding.  

2. Are you HIPAA compliant? 

Confirm that the RCM partner complies with the Health Insurance Portability and Accountability Act (HIPAA) regulations to protect patient data. 

3. Do you offer revenue cycle analytics and reporting to track key performance indicators? 

Review their ability to provide regular financial reports and insights for performance evaluation. 

4. What services do you offer within RCM? 

Understand the full scope of services offered, including billing, coding, claims processing, and denial management. 

5. Do you integrate with our current EHR/EMR systems? 

Make sure there is an integration with your existing Electronic Health Records (EHR) or Electronic Medical Records (EMR) system to minimize disruptions. 

6. What is your approach to revenue cycle optimization? 

Ask about their strategies for improving revenue collection, reducing denials, and accelerating cash flow. 

7. How do you handle coding and documentation compliance? 

Ensure they follow industry-standard coding practices and have a system in place for monitoring compliance. 

8. Do you offer A/R cleanup? 

Make sure they offer Accounts Receivable clean-up services. This will help you collect on outstanding balances and better organize future collections. 

9. Can you provide references from current clients? 

Request references to gain insights into the company’s track record and client satisfaction. 

10. What is your pricing structure? 

Ask for a breakdown of their fees and how they charge for their services. 

11. How do you handle the credentialing process for providers? 

Confirm that they can manage provider credentialing with insurance companies efficiently. 

12. Do you assist with Medicare/Medicaid billing? 

Medicare/Medicaid billing can be complex with ever-changing rules and regulations. Partnering with a knowledgeable RCM company that assists with these claims ensures prompt reimbursement. 

13. How do you handle denied or rejected claims, and what is your success rate in claim resolution? 

Claim denials are an incredible bottleneck in cashflow, disrupting the revenue cycle. Ensure you work with a partner that can improve claim accuracy and quickly resolve denials. 

14. What is your response time for resolving issues or inquiries? 

Get an idea of their responsiveness and availability for addressing your concerns promptly. 

15. What technology and software do you use? 

Be sure to confirm that the potential RCM partner’s use of up-to-date technology and software to enhance efficiency? 

16. How do you ensure data security and backup? 

Assess their data security measures, including backup and disaster recovery plans. 

17. What is your average reimbursement rate? 

Get insights into their success in maximizing reimbursement rates for their clients. 

18. Can you provide training for our staff on RCM processes? 

Inquire about their willingness to train your staff for seamless collaboration. 

19. Do you have a dedicated team? 

Determine if there will be a dedicated team or point of contact for your organization. 

20. How do you stay updated with industry changes and regulations? 

Be sure that the RCM partner is proactive in staying informed about healthcare industry changes and adapting to new regulations. 

Choosing the right RCM partner is a critical decision that can impact your healthcare organization’s financial health and overall success. By asking these important questions, you will be able to make an easier, more informed decision in choosing a revenue cycle management company that aligns with your specific needs and goals.  

Ready to start looking for an RCM company? Use the questions above and reach out to one of our revenue cycle management experts to see how Therapy Brand’s RCM services can help improve your cash flow today.