Clean ClAImsFirst Pass

Questions to ask any End-to-End RCM vendor

Every vendor in this category demos well. These are the questions that separate a product that will work on your volume, payer mix, and staff from one that works in the sales deck. Take them into the demo.

1
What net collection rate and cost-to-collect improvements do you guarantee, and what happens if you miss?
2
What happens to our existing revenue cycle staff: rebadge, attrition, or retention?
3
Where is the work performed (onshore/offshore) and what are the PHI controls?
4
What technology do you bring versus run on top of our systems?
5
How do we exit: what does unwinding the relationship look like operationally and contractually?
6
Which KPIs are in the SLA, measured how, reported how often?
7
Who are your last three clients that left, and can we call them?
8
How is your pricing tied to our net patient revenue, and what is excluded?

The 8 End-to-End RCM vendors we cover

R1 RCM

The largest end-to-end RCM operator

Health systemsHospitals

Ensemble Health Partners

Full-service RCM with operator DNA

Health systemsHospitals

Conifer Health Solutions

End-to-end revenue cycle services from a Tenet subsidiary

Health systemsHospitalsMedical groupsEmployers

Omega Healthcare

Global outsourced revenue cycle, coding, and clinical services

Health systemsMedical groupsBilling companiesPayers

Access Healthcare

Global tech-enabled revenue cycle services at scale

HospitalsHealth systemsPhysician groupsBilling companiesRCM firms

TruBridge

RCM services and EHR for rural and community hospitals

Rural HospitalsCommunity HospitalsHealth SystemsClinics

CareCloud

Outsourced RCM plus cloud PM and EHR for ambulatory groups

Physician PracticesMedical GroupsBilling CompaniesHospitals

Veradigm

Ambulatory RCM, clearinghouse network, and healthcare data at scale

Physician PracticesHealth SystemsPayersLife Sciences

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First Pass covers End-to-End RCM and the rest of the getting-paid stack every Thursday.