Top Three Questions for Choosing an Epic-Integrated RCM Vendor

If your healthcare organization is using Epic and considering a new Revenue Cycle Management (RCM) solution, there are essential factors to consider. As Epic continues to lead the $34 billion electronic medical record (EMR) market¹, there are many RCM vendors claiming to offer seamless Epic integration. However, not all integrations are equal. Understanding how each vendor integrates digital solutions across the RCM lifecycle is crucial to ensure the platform meets your organization’s specific needs.

Here are three essential questions to ask when evaluating RCM vendors with Epic integration: 

1. How does the vendor define “integration”?

As you evaluate RCM solutions for your healthcare organization, clarify how each vendor “defines” integration to ensure your expectations are aligned. Key considerations include:

Comprehensive Claims Handling: Does the vendor manage both Hospital Billing (HB) and Professional Billing (PB) claims? Can they provide advanced claim status updates or handle electronic attachments?

Specialized Packages: Does the vendor offer hospital-specific editing packages? Are they capable of integrating claim status, attachments, or advanced eligibility options?

Using customer references is an excellent way to learn more about the vendor’s implementation process and ongoing support. An RCM vendor with extensive Epic experience can anticipate and address common challenges, minimizing project delays and ensuring a smoother implementation.

2. Does the vendor optimize workflows from the end-users’ perspective?

Integrating an RCM solution with Epic is an opportunity to automate manual processes such as eligibility and benefits verification, claim scrubbing, submission, and status checks. However, understanding the real-world workflows of your staff is crucial for successful automation. Rather than relying solely on handbooks or process documents, the vendor’s team should engage directly with your employees.

Look for vendors with a history of successfully integrating RCM solutions that optimize workflows within Epic. A vendor who understands how your staff performs their duties can reveal pain points and areas for automation. The goal is to keep your team working within Epic as much as possible, avoiding the need to switch between systems.

3. Do you have a change management plan in place for an Epic integration?

Change management is vital for a successful RCM implementation. Without it, you may face issues with staff morale and slower-than-expected user adoption. A well-structured change management plan can mitigate these risks. Key considerations include:

Communication: The RCM vendor should develop a plan to keep staff informed about the project’s purpose, progress, and milestones. Effective communication helps address concerns and fosters a positive attitude towards the change.

Training Resources: The RCM vendor should ensure that comprehensive training resources are available to minimize productivity disruptions during and after the transition. Training should be tailored to different user roles to maximize its effectiveness.

By addressing these questions, healthcare organizations can better navigate the complexities of integrating a new RCM solution with Epic, leading to improved operational efficiency, reduced errors, and enhanced financial performance.

Why Partnering with Availity is the Right Choice

Availity Essentials Pro™ simplifies claim and payment processing through an integrated, all-payer clearinghouse that features robust pre-service, post-service, and post adjudication capabilities. Availity’s deep integration into Epic for end-to-end revenue cycle is used by more than 145 hospitals, health systems, and group practices across the nation, representing 112 million covered lives and 12 billion transactions every year.

Built on a 15-year foundation of deep integration and real-time data exchange, the relationship between Availity and Epic is the best-kept secret in health IT. In fact, Availity’s pre- and post-service revenue cycle integration is so seamless that providers working in Epic likely don’t realize that they are using Availity! The alignment between Availity and Epic fosters a more robust, data-driven approach to improving patient health, facilitate timely access to appropriate care, and eliminating administrative burdens.

If you’re interested in learning more about Availity’s Epic integration, download our Buyer’s Guide or schedule a meeting with our team today!