Incorporating a new RCM solution is no easy task, no matter if you’re a large hospital system, a post-acute provider or a small physician practice. It’s bound to disrupt your day-to-day activities, and your team will undoubtedly need an adjustment period. By creating a plan-of-action ahead of time, you’ll avoid extra unwanted stress, making the entire implementation process that much easier to handle.
There’s no substitute for preparation
Creating a to-do list prior to implementation is essential to ensure your team is prepared to start working within a new system and with your RCM vendor partner. Some points to consider:
- Decide on a point of contact during the transition
- Delegate responsibilities to each employee within the system
- Set clear expectations for the team and your vendor partner for both pre and post-implementation
- Set up additional training based on the computer literacy of your staff
- Put focus on the alignment of clinical and administrative workflows
With a plan in place, you and your team will be much less likely to become overwhelmed as you adapt to the changes.
Setting expectations for your new RCM solution is arguably one of the most important steps in this process. You can’t be expected to track changes or realize ROI if you don’t know what part of your RCM operations need improvement. Evaluate your current processes to see what areas are the most inefficient. From this observation and any measurable data collected, you can create your list of expectations and develop goals to meet them.
Your list of expectations and goals in using your new RCM solution might include:
- Reduce days in accounts receivable
- Determine top reasons for claim rejections and denials
- Find reimbursement rates for line-item denials
- Identify payment speeds by payer or specific bill codes
- Improve workflow and processes to streamline overall billing procedures
What to expect during implementation
Once the process is underway, your vendor’s implementation team will lead you through the process of setting up your paperwork and connections to your payers, including Medicare, Medicaid and any commercial payers. As many providers know, submitting your Medicare paperwork can be a giant task. Your team and vendor partner must be detail-oriented. Any errors (e.g. wrong authorized signer) no matter how small, will be instantly rejected by Medicare, and the one to two month approval process will unfortunately start over.
While setting up payers in your new RCM solution, stay pro-active by having your point of contact coordinate training sessions with the vendor’s implementation team based on your employees’ needs. It’s better to get this on everyone’s schedule early rather than trying to squeeze it in a few days before the solution launches. There shouldn’t be any surprises about your go-live schedule. Expect your vendor partner to contact you up to six weeks before your go-live date to schedule both training sessions and hammer out final go-live details.
It’s important to remind your team to be patient, as implementing a new solution is an on-going process you and your vendor will work in tandem to tweak as you go. This is a good time to begin setting up weekly meetings with your team and bi-weekly meetings with your sales representative to ensure everything is running smoothly and you’re on track to hitting your established goals. By leveraging your vendor relationship representative and implementation team on their product knowledge and recommendations, you’ll be well on your way to improving reimbursement through an efficient revenue cycle system.