Revenue Cycle Management (RCM)

Outsourcing medical billing is a significant decision for any practice. Unfortunately, too many practices fail to evaluate revenue cycle management services vendors properly before making their decision, resulting in higher costs and lower quality of service. BlueFish Medical recommends considering the following criteria when selecting a vendor:

1. Does the candidate vendor outsource or offshore any portion of their business to overseas vendors?
2. What performance guarantee does the vendor offer?
3. What key performance indicator (KPI) reports do they provide monthly?
4. Does the vendor provide adequate analysis of key performance data and regular help developing action plans to improve results?
5. How much experience does the vendor have serving customers in your particular specialty?

All of the above questions are critical to choosing the right revenue cycle management (RCM) vendor. Let’s review each one in the context of BlueFish Medical.

1. Using a domestic labor force, in our opinion, is essential. Offshore labor introduces numerous unnecessary challenges, including language barriers, time zone hassles, poor training standards, lack of understanding of U.S.-based medical billing practices, posting errors—and the list goes on and on. RCM vendors never choose to offshore their labor to improve quality; they do so to increase their profit margins at the expense of quality service.  BlueFish Medical believes a well trained and motivated U.S. labor force ensures a higher standard of performance, which improves our business—and yours—in the long term.
2. For our revenue cycle management customers, we offer our BlueFish Medical Performance Guarantee. We are committed to keeping rejected, denied and appealed claims to a minimum, and we stand behind that commitment by offering a credit on your next monthly bill if we exceed a mutually agreed upon number of claims or a maximum age for each status. Ask your current vendor about their performance guarantee. You’ll likely be answered with a long pause!
3. KPI reporting is essential, but most RCM vendors don’t provide monthly reports or train customers in how to evaluate them. That’s because most vendors see financially savvy customers as difficult to satisfy. But at BlueFish Medical, we believe informed customers are happier customers. That’s why we provide monthly KPIs plus management and consulting reports. These allow us to track trends in key metrics, measure RVU’s earned, and offer peer comparisons.
4. Your practice must also know how to take action to improve results, so our management and consulting reports provide in depth analysis of the data and suggestions of how to improve in the next reporting period. We also schedule monthly calls to review your data and develop plans to improve financial results. At BlueFish Medical, we believe the process of continuous improvement is the cornerstone of better financial results.
5. Specialty experience is also important. Ask your candidate vendor how many other customers they have in your specialty. If they are arranged in teams, ask if your practice will be placed in a team that is currently billing for other providers in your specialty. At BlueFish Medical, we would put our nearly 50 years of combined experience in healthcare up against any competitor at any time.

At BlueFish Medical, we believe all of these topics are essential to developing a great partnership with your RCM vendor. If you are looking to outsource your billing or replace your current RCM vendor, please contact us today so we can learn more about your specific needs.