6 Critical Considerations When Choosing an Outsourcing Partner

The choice to outsource is never an easy decision. Particularly when it comes to outsourcing elements of the revenue cycle – whether it’s coding, auditing, clinical documentation improvement (CDI), or various accounts receivable functions, careful consideration and evaluation of all outsourcing options is critical to a successful partnership. The work a potential outsourcing company will perform on your behalf will be a reflection of your organization and has significant regulatory, compliance, and financial implications. That’s why making sure you pick the best outsourcing partner available is essential to your long-term success. Here are key features to look for throughout the decision-making process:

1. 1. The Best Technology – The ever-changing world of technology is a lot to keep up with for busy healthcare organizations whose primary focus should be patient care. That’s why your outsourcing vendor should be investing in the latest advancements in technology, so you don’t have to yourself. In fact, that’s one of the primary reasons outsourcing will save you money. With the right outsourced partner, healthcare organizations don’t have to waste time researching and vetting which technologies can solve their problems and best improve the efficiency of their operations, nor do they have to spend the up-front capital to fund the implementation and ongoing support of such platforms. Many outsourcing organizations have invested in newer technologies such as computer-assisted coding (CAC), artificial intelligence (AI) and predictive BI analytics to ensure processes are as accurate, efficient, and seamless as possible. Tip: When evaluating a prospective vendor, ask them how much they invest annually in their technology and do your homework to know what they are offering is best-in-class when it comes to software.

1. 2. Ongoing Training and Education – The field of medical coding and claims billing is extremely dynamic – things are always changing. Another way outsourcing can save organizations some serious money is in the reduction of labor costs related to industry certifications, continuing education programs, travel expenses, and other related training and development expenditures. These costs can really add up – both through the out-of-pocket expenses incurred and the time spent away from productivity. The best outsourcing partners not only include their staff’s training and certification costs, they can also serve as an extension of your in-house team by providing ongoing education, training, and knowledge transfer to keep your staff current on the latest guidelines, rules, and practice standards. Tip: Ask all potential vendors what percentage of their coders are certified and what they do to focus on ongoing industry training and education for all employees.

1. 3. A Stellar Reputation – When it comes to outsourcing, there’s nothing more important than reputation and credibility. While evaluating potential partners, make sure they have worked with organizations of similar size and complexity and always ask for references. Check with your colleagues and industry contacts to see if you can learn more about the organization(s) you are evaluating. Lastly, check to see if they’ve won any industry awards, honors, rankings, or distinctions that may lend additional credibility to their operations and performance. Tip: Taking the time to do some due diligence throughout the outsourcing evaluation process may be time-consuming, but it is a critical component to ensuring you find the right partner.

1. 4. Delivers Value and Value-Add Options – Outsourcing any large health system function is a major decision, and one that typically starts as a cost containment measure. Aside from just helping your organization reduce expenses, a strong outsourcing partner will also deliver value. This could mean they help improve efficiencies and streamline processes, while allowing your in-house team to be more focused and effective. It can also mean they are scalable on-demand, allowing you to expand your team(s) during heavy volumes without the need for hiring additional staff. Finally, larger organizations may be able to support other areas of your organization that you didn’t initially plan to outsource, such as pre-authorizations, insurance verification, patient call center support and collection activities. Finding a partner who can augment numerous areas within the revenue cycle can lead to greater economies of scale and enhanced patient satisfaction. Tip: Even if you’re only looking to outsource one area of your revenue cycle to start (i.e., coding, billing, low balances, self-pay, etc.), take inventory of the additional functions each of your potential partners should handle and consider the value-add and savings for future expansion of services when comparing vendors.

1. 5. Organizational Alignment – Good vendors never want to be thought of as such. A truly effective outsourcing relationship should be a strong mutually beneficial partnership between two organizations that share similar missions, cultures, and values. If it’s important for your organization to keep some or all outsourced functions onshore, make sure your potential partner understands and can deliver accordingly. It’s also important to ask whether the vendor performs the work themselves or if they subcontract to other organizations, which will then require a secondary level of due diligence around the subcontracted entities. Also, remember that numerous individuals and areas within your revenue cycle will be working with your outsourcing partner on a regular basis – make sure it’s a team you trust and look forward to working closely with to drive common goals. Finally, make sure you have a dedicated account support team that you can call upon to collaborate with and/or for any questions or issues that may arise. Tip: Be sure your leadership team has an overall good “gut” feeling about the vendor you select. Balance this gut feeling with all the research you’ve done before making a well-informed decision.

1. 6. Comprehensive Business Continuity Planning (BCP): Strong BCP has never been more critical than in today’s ongoing “unknown“. While evaluating a potential partner, it is extremely important to understand how in-house and/or outsourced services might be impacted in the event of any unforeseen natural or man-made disruptions and what specific BCP is in place for such occurrences. The core focus of BCP is to offer quick-to-action and cost-effective solutions for easy adaption across several locations and demographics that offer minimal to no disruption. Comprehensive BCP should be multi-tiered, have a clearly defined scope and related objectives, a strong risk assessment methodology, current technology monitoring mechanisms, and continuous evaluation of the program’s protocols and effectiveness. It is also important to know if an outsource partner has a dedicated BCP task force, a crisis management team, and/or a BCP governance unit to implement the plans without disruption. Additionally, it should include having key leaders fully committed to effectively operationalizing the plans to ensure a smooth and seamless transition. Tip: Don’t hesitate to ask about infrastructure and support to implement or augment BCP and be sure to inquire about the frequency of how often the BCP is updated to remain current.

GeBBS Healthcare Solutions is a KLAS rated leading provider of Revenue Cycle Management Service. Our innovative technology, customized services, and comprehensive business continuity plan with over 9,500 employees help clients improve financial performance, avoid risk, and enhance patient satisfaction. To Learn more, visit: www.gebbs.com