Considerations when hiring Revenue Cycle Consultants and/or Interim Managers

Almost all provider organizations engage Revenue Cycle Consultants or Interim Revenue Cycle Managers from time to time. A lot has been published through HFMA about vendor selection criteria and vendor management. Most professional organizations offer a resource guide that lists options.

That said, here are two practical things to consider when hiring these resources:

1. Far too often when organizations hire external resources that will be deployed to their patient financial services, finance or health information management departments, they consider only the person OR the company supplying the resource. In order to better leverage your investment; be certain that you are hiring quality resources supported by an offering company with deep expertise in revenue cycle management operations.

   You are importing expertise and human capital to your organization and those values are not found in the company logo, rather they are delivered through the people serving you. Therefore, it is important to interview the specific people who will be working with you. Is the chemistry good? Do they have the technical background required? Have their achievements with other clients been commensurate with expectations you have in your organization? This interview process allows you to access what you are buying without the influence of a logo, business development person or other external factors.

   It is then a value added if you select a professional services company with the capacity to leverage the people selected. Once you have interviewed the consultant or interim director, pursue how the offering vendor achieves synergy by supporting the engagement with a brain trust, technical depth, management practices and other props. At Nearterm, we have (a) a quality assurance program called Q-100, (b) Principals with successful background leading provider organizations and (c) a mechanism for our field professionals to access our collective resources and expertise on a real time basis when engaged in development and/or problem solving endeavors. As a result our clients have the benefit of professionally managed resources with access to a cache of experience, eliminating the “trial and error” approach.

2. We always have to consider cost. I submit that in most cases, when provider organizations identify sustained operating deficits, performance problems, extended vacancies in key positions and backlogs, the real cost is in NOT getting help from an external resource.

   If these items could have been addressed internally, they would have already been resolved. Losses can be measured in terms of cost of cash and also balance sheet losses. Often the extra set of eyes and new ideas represented by an interim CFO or interim Business Office Director are just the change catalyst needed to improve performance. An Interim Controller can assist finance with accelerating close schedules and new formatting so that management reports are more timely and useful. Regardless of the issue, always think about the cost of inaction in terms of financial performance and even career development.

Billing backlog, collection backlog, posting backlog – what is the right option?

There is no “cookie cutter” solution because the factors contributing to processing backlogs vary. Here are just a few:

• System conversion
• Limited labor pool
• Space constraints
• Volume increase
• Training deficits
• Ineffective work flow design
• Change in payor requirement
• IT problems

The first step is to understand the root cause of the backlog and establish (a) an acceptable timeframe for resolving the backlog and (b) a mechanism to prevent recurrence. The result is almost always a determination that part of the game plan should include additional resources. That is when the question of options becomes critical. Conventional options have summarily included:

• Hire more staff and accept the time required to train them to the point where they are effective
• Outsource to a vendor with a remote processing venue
• Bring in skilled temps (interim collector, interim biller)
• Some combination of the above

There is another viable option not mentioned above that is very effective – REMOTE AR SPECIALIST. This would be a highly skilled, experienced collector, biller or insurance follow-up person(s) that would work from home with access to the provider system. Typically, this resource would initially work at the provider site for a short time getting familiar with the systems, people, policies and other critical orientations. Work standards would be established and the AR SPECIALIST would then work from home, saving travel cost and eliminating the need for work space at the facility. This very contemporary approach is available through Nearterm Corporation and has worked very well for many provider organizations.