Most ASC revenue cycle management problems are caused by a lack of resources, according to Jessica Nelson, the director of revenue cycle services for perioperative IT provider Surgical Information Systems.
Here are Ms. Nelson's tips on what to look for in an RCM consulting firm.
1. Revenue cycle assessment and optimization strategy.
"Any good RCM consultant will always start with an assessment of your current RCM processes and come up with a plan for improvement," Ms. Nelson said.
Consultants should be thorough in their analysis: meeting with experts every day, establishing a baseline, discovering the sources of poor performance, prioritizing issues and developing a detailed strategy complete with targeted milestones.
2. Constant monitoring and adjustments to RCM processes.
The revenue cycle process requires constant attention to remain optimized. RCM consulting firms should monitor scheduling, admissions, verification, charge capture, billing, collections and payment posting using a business intelligence tool.
3. Relevant certifications.
Certifications provide a baseline indicator that a firm has necessary training. Ms. Nelson recommends looking for these three certifications:
- AAHAM Certified Revenue Cycle Executive/Professional/Specialist
- AAPC Certified Professional Coder
- AHIMA Certified Coding Specialist
4. Positive references and experience working with similar organizations.
Ask the firm to provide contact information for previous clients, and solicit feedback on the consultant from facilities similar to yours.