Understanding the Claims Lifecycle: A Step-by-Step Guide
Grasping the details of the claims lifecycle in healthcare is crucial for getting timely reimbursements and maintaining financial well-being. As...
Across the industry, provider organizations are experiencing pressure due to staffing shortages, payer challenges, shrinking margins and constantly evolving regulations. In response, vendors are developing comprehensive platforms that house a full suite of revenue cycle solutions in one place.
These RCM platforms are tailored to navigate today’s revenue cycle challenges, offering data-driven insights for proactive decision-making by healthcare finance departments.
Cheryl Alden, Chief Marketing Officer at FinThrive, noted in a recent interview with HealthLeaders that healthcare organizations following the COVID-19 pandemic had to quickly adapt to new care delivery models, patient expectations and workforce shortages, all under new economic constraints. This impacted how finance leaders prioritized RCM solutions, leading to a greater emphasis on end-to-end platforms.
“RCM technologies are a top investment for health systems going forward,” Alden said. “It’s in this context that the so-called “end-to-end” platforms have become increasingly relevant, offering advanced insights that connect all the dots.”
And while the benefits of end-to-end RCM platforms are obvious for many healthcare organizations, it’s important to understand what these platforms are not. We’re here to debunk three common myths that have been circulating around end-to-end RCM platforms.
Myth #1: Buying an end-to-end RCM platform must be “all or nothing”
When it comes to implementing new technology of any kind in a healthcare setting, often doing so a little bit at a time is the best way forward.
For example, healthcare RCM automation is profoundly impactful in increasing efficiencies, improving staff satisfaction and creating a stronger bottom line. But rather than setting out to automate big-picture issues, such as improving a claims process, it’s best practice to automate the “low-hanging fruit” first – data-rich tasks that are manual and repetitive.
Over time, setting automation goals and scaling slowly allows your team to diligently build a robust process that produces greater ROI in your RCM strategy.
With end-to-end RCM platforms, healthcare finance leaders may feel a similar pressure – to go “all or nothing” – but Alden says that is rarely the best step forward.
“In reality, the path to RCM platform adoption is not a one-size-fits-all,” Alden said. “Few providers are in a position to wipe out their existing RCM technology stack and deploy a full replacement despite some of the advantages.”
The key is for RCM vendors to offer flexibility in their platform, so providers can implement and adopt solutions at a pace that best meets their unique needs.
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Myth #2: End-to-end RCM platforms can’t scale effectively with an organization
A dependable RCM partner recognizes the significance of scalability and possesses the flexibility and resources to adjust to evolving requirements and growing operations.
“For starters, the definition of “end-to-end” is not standard and is something to pay attention to,” Alden said. “RCM platform vendors have typically grown through a combination of building and buying, leading to a mix of capabilities across the category.”
Provider organizations may worry that end-to-end RCM vendors are only focused on current challenges without the future in mind. As healthcare organizations grow, would an end-to-end platform be prepared to grow with them? Or would these organizations be right back where they started – looking for another RCM technology platform to solve for their newest challenges?
“It becomes imperative for providers to select an RCM partner that has the breadth of technology solutions for both today and tomorrow while not sacrificing quality and capability,” Alden said.
Myth #3: The only important aspect of an end-to-end RCM platform is the technology
The quality of any technology, especially when evaluating RCM vendors, is crucial to the overall success of the investment. Without the tech working properly, finance leaders won’t get the ROI they expect.
And while product quality is usually top of mind, it’s not the “end all be all” for an end-to-end RCM platform. To get the most ROI from a platform provider, it’s equally important to consider a vendor that acts as a partner at every stage, offering top-tier service and support.
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Alden stresses the importance of a partnership between the vendor and healthcare organization.
“Revenue cycle teams want systems built by revenue cycle professionals,” she said. “A partner should have a deep understanding of the revenue cycle and be committed to a long-term relationship.
According to Alden, the right end-to-end RCM technology partner should:
- Offer a consultative approach to their provider customers
- Help providers navigate the common pitfalls of RCM technology
- Advise and deploy best practices for customers to achieve better financial outcomes
Understanding the realities of end-to-end RCM platforms is crucial for healthcare organizations navigating today’s complex revenue cycle landscape. By dispelling common myths and embracing the strategic implementation of these platforms, providers can optimize their operations and drive sustainable financial success in the evolving healthcare environment.
To read Cheryl Alden’s full interview with HealthLeaders, click here. Plus, learn how FinThrive’s end-to-end RCM platform pulls data from multiple solutions into a single enterprise view, helping healthcare finance leaders understand both gaps and opportunities in their revenue operations.
