Factors for Successful Offshoring of Revenue Cycle Management Services

ThoseconsideringoffshoringtheirRCMmayhavequestionsaboutsetting theirteamsupforsuccess.Therightpartnerwilleaseanyconcernsandinstill confidenceinyourteambyleveragingcommonlyusedprojectmanagement toolsandengaginginopen,honestcommunication.

Whenconsideringthelifecycleoftheengagement,herearesomebest practicesyoushouldwatchfor.Onceyou’vedecidedtooutsource,youand youroutsourcingpartnershouldworktogetherto:

• Clearly Define the Scope of Work in the RFP: Definingthescopeof workhelpstoeliminateanyambiguity.Forexample,withA/R,what rangewouldtheRCMteamwork?Whenconsideringtheservicesyou expectfromyourRCMpartner,what'sinscope?Whoisresponsibleon thecustomerandvendorsides?Thisisalsoagreattimetodefine volumessobothteamscanstaffappropriately.

• Define and Document RCM Partner Capabilities: Duringcontracting discussions,itisessentialtofullyassessanddocumentthecapabilities ofyourselectedRCMvendor.Ifthisstepisoverlooked,itcanleadto confusionanddisruptionsdowntheroad.

• Be Transparent About Cultural Differences:Youmustunderstand culturaldifferencesandwhattoexpect.Forexample,inIndia,people aregenerallytaughtfromchildhoodtorespectandbeagreeabletotheir eldersdespitedifferencesinopinion.Thiscantranslatetoaneedfor morecomfortwithquestioningorpushingback.IntheU.S.,peopleare commonlytaughtfromayoungagetoquestionthings.Weare empoweredto‘dothingsinnewways.’Whenselectingapartnerwith anoffshoreteam,it’simportanttofamiliarizeyourselfwithcultural differences.

AtAGSHealth,projectmanagersbasedinIndiareceiveadditional trainingonculturaldifferences.Theyareencouragedtoaskquestions andofferguidancetocustomers.AGSiscommittedtocreatingamore consultativeteamsocustomerscanunderstandwhatsystems, processes,etc.,areworkingforotherhealthcareorganizations.And theyhaveateamthatisempoweredtoengageinandguidethose discussions.

• Customer-Side Support Must Be Present: RCMiscomplex,andwith eachhealthcareorganizationdoingitsRCMdifferently,itisn’ta‘liftand shift’operation.Teamsonbothsidesmustsupportthetransitionandbe activelyengagedthroughouttheproject–especiallyduringthefirst18 monthswhenprocessesandsystemsarebeingestablished.

• Clearly Define Success Factors: Whatdoessuccesslooklike?Are thesefactorssharedwithalltheappropriateteammembers?Aligning onsuccessnotonlyunitesteammembersbutalsogetsthemworking towardasharedgoalandhelpstokeepthemontrack.

• Set Clear Expectations for Measurement: It’shardtomeasure progresswhentheteamsareclearaboutthemetrics(fromthe customerandvendorsides).Todeterminemetrics,it’simportantto reviewhistoricalperformancewhensettingtargets. Thisnotonlyhelps toensuregoalsarerealistic,butitalignsteammembersfromboth companies.

• Define Productivity Expectations: Usinghistoricalperformancedata andfeedbackfromtheRCMvendor,whatarerealisticexpectationsfor

productivity?Productivityexpectationsmustbedocumentedand providedinasharedlocationwhereallteamscanaccessthe information.

• Understanding Gaps: Oneelementofriskmitigationinvolves understandinggaps.Forexample,crackscanoccurwhenthereare culturaldifferencesorwhenthenextstepsaren’tclearlydefinedatthe closeofameeting.Howmanytimeshaveyoubeeninaforumwhen everyonewalksawaywithadifferentunderstandingofwhat transpired?Tocontrolthesegaps,it’shelpfultohavedetailed documentation,includingmeetingnotesthataresharedandsignedoff onbybothorganizations.Again,thegoalistoensurethatallteam membersarealigned.

• During the Transition, Perform a Soft Launch: It’sessentialthatRCM outsourcingisn’tviewedasa‘liftandshift’project.Teamsfromboth organizationsneedtobeinvolved,motivated,andparticipating.Forthe firstfewweeks,yourteamneedstoreviewtheRCMpartner’sworkto ensureitmeetsyourexpectations.Yourteammembersmustmaketime forthiscriticalstep.Auditingtheworkforthefirstfewweeksallows youtoprovidefeedbackandallowsyourvendortomakeadjustments. RCMworkflowsareverydifferentfromorganizationtoorganization,so thisisanexcellentopportunityfortheteamstogettheprojectofftoa greatstart.

• Quality: YouandyourRCMVendorneedaclearanddocumented understandingofhowqualitywillbescoredandmeasured,aswellas thefrequencyofqualityreviews.Qualitydeliveryiscritical.Thiswill helptoensuretheteamshaveasharedviewandunderstanding.

Collaboration is Critical

Whilealltheaboveareessentialforsuccessfuloffshoring,otheractivitiesare equallyimportant.Theseactivitiesrequirebothteamstoworktogetherand haveopenandhonestdialogue.

Processdocumentationtocapturecustomerworkflowsandhowthe customer'srevenuecycleworksisessential.DocumentingStandardOperating

Procedures(commonlyknownasSOPs)alsohelpstoensurefulltransparency forallinvolved.Ifthesedocumentsaren’treadilyavailable,youandyour vendorwillneedtoworktogethertobuildthesedocumentsandhavethem approvedbybothpartiesbeforeworkbegins.Thesetypesofrecordshelp ensurethat,fromanoperationalperspective,bothteamsarefullyinformed.

Other Critical Success Factors

Whenoffshoring,yourorganizationshouldexpecttohavethefollowingteam membersassignedbyyourRCMpartner:

• CustomerSuccessRepresentative

• ProjectManagers

• TransitionManager

Theabsenceofanyoftheserolesshouldraisealarms.Theseindividualsare criticalforasuccessfulengagement.

Additionally,anynewtransitionrequirescalibration.Thisallowstheteamto identifyanyfurthergaps.RCMiscomplexandeachhealthcareorganization hasuniqueteamcompositionsandoperatingprocedures.Acommitmentto

continuousimprovementthroughperiodicevaluationshelpstheteamalign, addresspotentialissues,andrecommittothegoals.

Open, Honest Communication

Inmanyinstances,whenpeopleoffshore,theymayreplaceteammembers thatpossess15-20yearsofcodingexperiencewithoutsourcedteammembers whoarerelativelyfreshintheircareerjourney.Assuch,theRCMpartner shouldperformsomebasicactivitiestoensurequalityoutput,suchas:

• Conductingregularauditstoensurevitalcodingaccuracy–andputting plansinplaceforteammemberswhodon’thittheirqualitybaseline.

• Providingongoing,rigoroustrainingforcoderstoensuretheyare familiarwithcodingchangesandupdates.

Day-to-Day Support

It’sessentialtokeepstaff(onbothsides)motivatedandengaged.Onewayto dothisistotietheproject’ssuccesstoindividualperformancereviews.If peopleknowtheirmeritincreasesdependonthesuccessoftheRCM transition,theyaremorelikelytobemotivatedandactivelyparticipate.Tying teamperformancemetricstotheprojectisagreatwaytoensuretheproject remainsapriority.

Additionally,forRCMvendors,it’sessentialthatprojectmanagersbeclear abouttheimportanceofcustomersatisfaction.

Havingavaluemindsetneedstobetopofmindforeveryoneinvolvedinthe project.

The Value of Meetings

Regularmeetingshelpteamsdiscussprogress,addresschallenges,remove barriers,reviewmetrics,andshareconcerns.Engagementinallaspectsofthe project,beyondthemetrics,isessential.Thisisagreattimetoreview processes,KPIs,andleadingindicators.

Monthlybusinessreviewsprovideopportunitiestoreviewperformancedata anddiscusshowthepastmonth’sperformanceismeasuredagainst expectations.

Strategicquarterlymeetingsthatinvolveleadersofbothcompaniesarealso critical.Duringthesemeetings,it’scriticaltodiscuss:

• Industrytrends

• Anychangestoyourorganizationalstrategy

• Organizationalchangesthatcouldhaveasignificantimpactonthework beingdone

• Priorities

Conclusion

Withalltheseelementsinplace,youcanrestassuredthatyourteamandyour RCMpartnerwillbeonapathtosuccess.Themostimportantelementthat everyonemustagreeonishavingateammindset.Don’ttreatyouroutsourced partnerasavendor.Bestresultsareoftendeliveredwhenvendorsaretreated asanextensionofyourteam.Ateammindsetwillhelpeveryonestay motivatedandviewtheprojectasapriority.

Source of Content: AGSHealth Blog - Factors for Successful Offshoring of Revenue Cycle Management Services