Enhancing Healthcare Revenue Streams: Key Steps for Your RCM Team to Improve Patient Collections
According to a recent survey from the Healthcare Financial Management Association (HFMA) and Eliciting Insights, hospitals and health systems find...
In the ever-evolving landscape of healthcare, finding the right insurance discovery partner is crucial for maximizing revenue recovery and ensuring the financial health of your organization. The process can be daunting, but understanding what to look for in a partner can make all the difference.
Here are tips that can help simplify your search for the right vendor.
Tip #1: Find an insurance discovery vendor with a proven track record of success
All vendors can talk the talk, but which ones can walk the walk? Getting the answer to this question can be the in whether you’re successful in your search for an insurance discovery vendor.
The history of the company matters significantly. A partner with a strong market presence, widely accepted products and solid performance history offers reassurance of their capability and reliability.
Plus, a proven track record of success is crucial in a constantly evolving healthcare industry. Experienced vendors can best adapt to change, and ensure they are best positioned to strengthen your bottom line by discovering the most coverage and revenue opportunities.
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Tip #2: Find a vendor that provides a seamless onboarding experience and ongoing customer support
Whether your healthcare organization is transitioning from another vendor or implementing an insurance discovery for the first time, a smooth onboarding process is crucial to getting off on the right foot.
No two healthcare organizations are the same, though. To achieve a seamless implementation experience, make sure the vendor is committed to an open line of communication and possesses a willingness to tailor an approach based on your requirements and customizations.
As the partnership continues, the vendor should provide a clear and accurate picture of what’s needed – and be eager to support you should any issues arise so that you can maximize your ROI.
Tip #3: Find a vendor with comprehensive coverage capabilities
Customer support is important, but finding the best insurance discovery solution also should require partnering with a vendor that can find you the most coverage possible.
An effective insurance discovery partner views the processes holistically, searching for coverage across all patient accounts regardless of age, insurance type or region. Coverage goes well beyond the broad categories of Medicare, Medicaid and commercial insurance.
Look for a vendor that’s constantly innovating their solution to maintain their ability to discover hard-to-find coverages. For example, vendors that leverage intelligent automation can search for coverage at every stage of the revenue cycle and go beyond traditional methods to find maximum coverage.
Tip #4: Find a vendor that offers a flexible pricing plan that aligns with your budget and strategic goals
Margins are tight for healthcare organizations. And while there are varying pricing models for insurance discovery solutions – subscription and contingency-based being the most common – knowing the total potential cost of solution compared to the potential ROI is important.
Subscription-based models: These models offer predictable fees and results are delivered swiftly. With this model, you’ll pay the set amount regardless of the volume or value of results you choose to act upon.
Contingency-based models: Alternatively, contingency-based models create a performance-driven environment that benefits both the vendor and the client. With this model, vendors are motivated to generate highly actionable findings, given that their compensation is tied directly to your reimbursement success. This model fosters a partnership where the vendor is deeply invested in the quality of the work, aligning their incentives with your financial recovery efforts.
Vendors that offer flexibility and transparency when it comes to pricing are best positioned to fit your needs, regardless of which model you prefer.
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Selecting the right insurance discovery partner is pivotal for enhancing the financial performance of your healthcare organization. By considering factors such as a partner's track record, support during onboarding, coverage capabilities and pricing model options, you can be on your way to making an informed decision.
For a complete roadmap to selecting the right insurance discovery vendor, download our Insurance Discover Buyer’s Guide. You’ll find more information on the tips discussed here, as well as four additional tips to further assist you in finding the right partner to meet your revenue goals.
