Revamping the Revenue Cycle Partnership: Emphasize Customization as a Core Pillar
Chandler Barron serves as the president of Parathon, an organization that empowers hospitals and healthcare systems by equipping them with tools to maximize the revenue they rightfully earn.
The competitive landscape of revenue cycle management (RCM) is intensifying, with payers setting up more obstacles to hinder hospitals from obtaining the revenue they're owed. To keep pace, hospitals and their RCM partners require flexible software that can adapt to payer changes, as they frequently play a zig-and-zag game where payers often zig while providers struggle to keep up.
The High Price of Static Solutions
The main reason for this struggle is often the lack of continuous updates and customizations from developers after launching the software. Once implemented, the software remains static, which is particularly detrimental in an environment where payers perpetually try to gain the upper hand. Without RCM partners that provide regular customization based on evolving payer requirements, hospitals risk falling behind, ultimately leading to missed reimbursements.
Many RCM partners are hesitant to invest time and resources into software customization, even if it would significantly benefit their clients. This reluctance can result in delayed customization requests or prohibitively high quotes as a deterrent, which leaves hospitals without the tailored support they need.
Innovation and Survival in Rapidly Evolving Environments
In today's complex and constantly changing RCM landscape, innovation and adaptability are no longer choices – they are necessities. RCM partners must prioritize continuous development and refinement, providing hospitals with the tools they need to swiftly respond to payer changes and stay one step ahead in the competition. Customization, far from being a luxury, is now a survival imperative for hospitals, as even minor inefficiencies can have substantial financial impacts.
For instance, Parathon's database was initially designed to give hospitals complete control over their revenue cycle from a single desktop across various electronic health record systems. This solution significantly increased efficiency and reduced operational costs by enabling staff to easily execute tasks without switching between platforms.
Additionally, the database also provided a backup system in case of cyberattacks, an unforeseen benefit that highlights the value of proactive and forward-thinking development.
Hospitals also have an opportunity to co-create innovative solutions with their RCM partners, like Phoenix Children's and Philips Healthcare did when they partnered to develop child-friendly imaging equipment. The project resulted in new dosing protocols and child-sized equipment that are now prevalent in pediatric imaging for Philips products worldwide.
Advocating for Your Hospital
In the tug-of-war with payers, hospitals often find themselves at a disadvantage due to payers' financial might and control. To level the playing field, hospitals must advocate for RCM partners that offer more than basic support and are committed to continuous improvement and customization.
Revenue cycle vice presidents and directors usually understand the value of customization, but ultimately, chief financial officers make the final vendor decision. To ensure you partner with a provider that offers the necessary support, consider asking potential partners the following questions:
- What flexibility does your software offer in adapting to specific billing rules?
- How do you allocate developer time for your clients, and how much is available?
- Do you offer custom development resources to adapt to our hospital/health system's coding logic and workflow processes?
- What resources do you offer to help align with the specific needs and regulations of our organization?
By demanding flexibility, innovation, and a willingness to develop customized solutions, hospitals are positioning themselves for long-term success. Access to up-to-date technology and the ability to respond to evolving payer requirements will help hospitals secure the revenue they're owed, ultimately minimizing disruptions to patient care and maintaining financial stability.
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- Given Chandler Barron's role as the president of Parathon, he might advocate for hospitals to partner with RCM providers that prioritize continuous development and offer customizable software solutions, ensuring hospitals can keep up with payer changes.
- In the context of the competitive landscape, Chandler Barron might highlight the importance of RCM partners like Parathon that provide regular customization based on evolving payer requirements, helping hospitals avoid missed reimbursements and maintain financial stability.
