Revenue Cycle Management (RCM) is central to a healthcare provider’s improvement in ROI and contributes to patient satisfaction. However, the in-house staff might spend more time in actual patient care, or are not fully trained in various RCM tasks. There may also be a talent shortage in these RCM specializations. These scenarios may lead to errors in patient information, high denial rates, and ultimately lost revenue.

This is why healthcare businesses are coming to global healthcare solutions partners to team up with and build teams to help them tackle pain points such as reducing billing errors, monitoring claims processes, and efficiently verifying patient eligibility, among others. Not only does partnering up with a solutions provider reduce costs, but it also gives businesses guaranteed results that meet and exceed their expectations based on their agreed KPIs, whether it be the accuracy of processing or improving denial resolve rate to improve healthcare revenue.

But before you go and search for a healthcare solutions partner, what should you look for? Here are 3 essential qualities in a healthcare solutions provider.

1. Expertise in Healthcare Processes

Is your healthcare company having a hard time focusing on RCM because your in-house staff is experiencing an increase in workload? Count on a healthcare solutions partner to help you organize healthcare processes such as patient eligibility, appointment setting, and patient concierge.

Choose a partner that understands your unique needs that creates flexible and customized solutions for tasks in:

• Clinic Documentation Integrity
• Medical Coding
• Medical Billing
• Claims Processing
• Other tasks within the RCM spectrum

Patients can have better experience and satisfaction given that they will know which services will be shouldered by their insurance provider and which ones they’ll co-pay. This will trust your company more and in turn, this will impact your company’s revenue flow.

2. Compliance with HIPAA and Other Legislations

Many healthcare providers hesitate when they want to partner with an outsourcing company because patient information might not be kept safe. Global healthcare solutions partners know that data security is an important aspect of their company, and will make great strides to keep your patients’ information away from any kind of cyberattack & security threats.

That’s why it’s crucial that your healthcare solutions partner is 100% HIPAA-compliant. This means that the patient data your business manages should be protected by the healthcare solutions partner that uses this kind of information. The outsourced team you work with should understand the nitty-gritty details of compliance programs so that they can help your business meet strict security requirements, such as intrusion detection and prevention systems, Palo Alto next-generation firewall, gateway antivirus programs, internet access control, and SSL-based connections.

Check if they’re also ISO-certified and following GDPR regulations, and if they are aware of California Consumer Privacy Act which will take effect on January 1, 2020.

3. Access to Expert Healthcare Specialists 

Are you experiencing challenges in hiring an in-house staff due to a high price job market? You might want to consider building a team with a healthcare solutions partner. Healthcare service providers nowadays turn to global solutions partners not only to reduce costs but also to acquire access to medical coders, billers, and claims processors. These specialists, from registered nurses with experience in a clinical setting to allied health professionals who specialize in medical coding and claims processing, can help you improve productivity efficiently with reduced errors.

With these three qualities in mind, you can look for the right healthcare solutions partner that can help you build a dedicated team of highly skilled RCM specialists as you focus on your competencies that improve and maintain high patient satisfaction, which ultimately leads to a better return of investment and reputation.

Infinit-O is the trusted customer-centric and sustainable leader in Business Process Optimization to Small and Medium businesses in the Financial Services, Healthcare and Technology sectors by delivering continuous improvement through technology, data and people.