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How to Deliver a Quality Client Experience


HBMA Billing July/August 2016

Read more from the latest issue of Billing.

As Executives Scrutinize Every Dollar Spent, Billing Companies Must Show Value

Changes in today's environment mean providers need more help than ever before managing their revenue cycle, with more scrutiny on their investments. According to peer60's "Healthcare Revenue Cycle Management 2015" report, 36 percent of providers said that as they plan to move toward value-based payment models, they will have to reduce their capital spend. Twenty-one percent of hospitals said they will need to eliminate vendors that are not producing an ROI.

Vendors that don't adequately monitor their efforts – track progress, highlight wins, and identify areas of opportunity – are at risk of losing out to their competitors.

But billing companies can show value by treating clients as true business partners, which includes everything from delivering a quality customer experience to showing a positive ROI. Start by taking a proactive approach to ensure expectations, goals, and outcomes are clearly communicated.

The following best practices can help establish and grow a positive client relationship:

1. Benchmark at the beginning of a new client relationship. Establishing benchmarks can provide a foundation on which to evaluate the relationship over time. Comparative data gives you the information you need to establish benchmarks, allowing clients to compare their financial performance against peers by both specialty and state. Benchmarking provides a snapshot of the business performance and shows where providers compare to their peers on particular standards.

Key areas to benchmark include:

  • Overall denial rates and the ability to drill down to identify which categories are experiencing the highest denials. Armed with this information, RCM companies can help clients determine the root cause for denials (instead of educated guesses).
  • Accounts receivable averages to see how the client compares to peers to determine whether A/R is in a normal range or if there are internal issues impacting a specific provider's ability to get paid in a timely manner.
  • Revenue-related trends and statistics: reimbursement, claim rejections and denials, collections, and payor trends all can reveal the financial health of a provider's practice and help determine processes and action items to improve operations.

Using a client's practice as a reference point, take a month-to-month comparison to determine what has changed: look at workflow, how quickly payments are processed, claim rejections, which payors are rejecting the most claims, and other benchmarks. Benchmarks should be set based on what the billing company can impact and also what the provider will need to resolve internally. Help guide your clients to the healthiest possible revenue cycle management level, whether you impact it or they do so internally.

2. Establish goals. Once you've established your client's benchmarks, set realistic goals that help evaluate:

Efficiency of the practice today;

  • Improvements over time, compared to past data; and
  • How far a practice needs to go to reach its goals.

Be sure to set reasonable and manageable goals while also managing the clients' expectations. For example, aiming to reduce denials from 20 to 6 percent overnight would not be a reasonable goal.

Once you've established your goals, document them and collaborate with your client for continuous dialogue and mutual agreement.

Also important: be sure to communicate your own priorities to the client and explain your rationale, such as priorities that will ensure the greatest ROI.

3. Treat the relationship like a partnership. Be proactive and foster open, two-way communication on a consistent basis. Leverage data to share and explain the positives and negatives.

Comparative analytics solutions allow you to capture insights that were not previously attainable. Billing companies that leverage comparative analytics solutions will offer the value and information that providers are seeking now and in the near future. This level of information is critical as healthcare executives continue to evaluate which vendors provide the greatest impact on their bottom lines.

Amber Civitarese is director of product management at RemitDATA. She has over 17 years of experience in the healthcare industry specializing in revenue cycle and product management. She develops long- and short-term product roadmaps that align with market needs and company goals. Focusing on analytic and workflow solutions, Amber works closely with product owners, developers, marketing, and end users to ensure product design aligns with market needs. Learn more about RemitDATA at

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