4 Steps to Streamline Your Revenue Cycle Tech Stack
5.24.2023 By Linda Perryclear & Krisi Hutson
The provider revenue cycle is notoriously complex, and even smaller providers can work with between five and 10 technology vendors just to support it. Choosing multiple, “best-in-class” vendors may seem like the best way to manage complexity, but there are good reasons to consider using fewer vendors.
When does it make sense to bring in vendor point solutions?
If your business has unique complexities related to population, specialty, or payer mix, you may require niche vendors to accomplish one small segment of your revenue cycle. You may still find opportunities to consolidate in the major pillars of your revenue cycle (like eligibility and claim submission).
For example, when you have multiple systems, it can be difficult to find and fix the root cause of a problem, which takes up staff time and can delay payment. Additionally, you may pay more for services a la carte, as most vendors will bundle solutions for a discount. Finally, logging into multiple systems may not seem like a big disruption, but it adds up over time and creates staff abrasion.
It can be daunting to develop and execute a plan for vendor consolidation, especially if you have multiple contracts of varying lengths and terms. We’ve put together four repeatable steps to evaluate your revenue cycle vendor stack and make regular review a part of your operations.
- IDENTIFY A PROBLEM
Start by identifying a problem statement: what issues are occurring in your revenue cycle and how are they affecting the business? We recommend identifying problems in your eligibility process first, since fixing those will have a positive impact on pre-service and downstream processes.
- OUTLINE A PLAN
It’s time to get out the whiteboard. Map out what vendors are part of your eligibility process (if that’s where you’re starting) and evaluate each vendor based on three pillars: relationship, workflow, and cost.
Ask yourself if you’ve achieved the results each vendor promised and if you’re happy with their level of service and partnership. If the answer to either question is no, reach out to your peer network for their vendor recommendations.
Invite your team to provide feedback on workflow gaps and overlaps. Check in with your preferred vendors to find out if they’ve introduced new solutions that solve those problems or could replace another vendor’s software.
Consider time savings, not just cost, when evaluating solutions. Solutions with a higher price tag may reduce manual workflows, which saves money in the long term.
At this phase you’ll also want to plan for success in implementation. Set specific, realistic, and measurable goals, like reducing denials by X% or reducing the time it takes to conduct Y. Make sure you have resources aligned both to implement and to measure the outcomes of implementation.
- IMPLEMENT AND MEASURE
Your vendor contract cycle may require that you take a phased approach to implementing changes, but this is a good plan of attack anyway. Whether you’re adding solutions or ending contracts there will be challenges. Set realistic expectations and lean on your success criteria to demonstrate the value to your team and organization. What success metrics did you identify in your plan? Conduct a time study with your staff, re-analyze your top denial reasons, or measure your clean claim rate against where you started.
Time studies before and after implementation help you translate time savings into cost savings. How long does it take to…
- Work an edit? A denial?
- Solve a support issue with a vendor?
- Manage a vendor’s contract?
- Complete an annual security review?
- CONTINUOUS IMPROVEMENT
Repeat steps 1–3 for additional revenue cycle issues, then conduct ongoing vendor evaluations
every two to three years. The frequency will depend on your typical contract length and the complexity of your vendor landscape.
However you choose to consolidate vendors, it’s helpful to keep in mind your ultimate goal: to bring clarity, consistency, and efficiency to your entire revenue cycle.
If you’re looking at clearinghouse solutions with end-to-end revenue cycle capabilities, reach out today for an Availity Essentials Pro consultation.