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How to Not Get Burned By Your RCM Vendor

How To Not Get Burned By Your RCM Vendor

Revenue cycle management (RCM) is one of the most important parts of your practice. Yet billing can be a rather challenging task for many practices, taking a significant amount of time and pulling staff attention away from your patients. Outsourcing your medical billing and RCM to a third-party vendor has many advantages, including allowing you to stay focused on your patients and provide them with everything they need and deserve. However, if you are not careful in choosing your RCM vendor, you may wind up getting burned.

Ask for Regular Reports

When you outsource your billing and RCM responsibilities to a third-party, you have no control over the staff. You don’t know who is working on your claims; that job is delegated to one of the employees of the vendor. It can seem like a scary situation when you haven’t met the person who is working on such an important part of your practice.

You don’t have to be completely in the dark about how your billing and RCM needs are being taken care of. You can request to have weekly reports delivered to your practice. This allows you to monitor how well the vendor is adding to your revenue cycle. You can also monitor the time between dates of service and payment dates.

Develop a Relationship with Your Vendor

Outsourcing your billing and RCM needs to a vendor means that if there is a billing issue, you can’t just walk down the hall and resolve the issue on the spot. If the issue stems from documentation errors, a vendor might down-code a procedure, which can result in significant losses. It is important to develop a relationship with your vendor, and call as soon as issues arise. If at all possible, find out ways to educate physicians about documentation issues to prevent them from happening again.

Ask about Hidden Fees

The cost of an RCM vendor can be expensive for smaller practices, which means these practices may not be able to afford outsourcing. Some vendors have hidden fees – startup costs, sending reports, cancellation fees. Others charge a percentage of what they collect for you. Not only does this mean that the more the vendor collects for you, the more they keep, it also means that if you have smaller claims the vendor might not pursue those claims as adamantly as ones that will bring in more money.

Collection is important to keep your practice running efficiently and up to date. The cost of an RCM vendor shouldn’t restrict the amount of money you receive, or worse, wind up costing you more. When choosing an RCM vendor, make sure that you ask about any fees that might be in the fine print as well as if the vendor keeps a certain percentage of the collections. If they do collect a percentage, ask how much.


There are many advantages to outsourcing billing and RCM responsibilities. But having a vendor can lead to issues if you’re not careful. Choosing the right one is important not only to avoid these issues, but also improve your revenue cycle. For help with all of your RCM and billing needs, contact The Midland Group today.

 

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