At a recent ACEP Democratic Group Practice Section meeting, leaders in emergency medicine discussed one of the most important decisions independent groups face, selecting the right revenue cycle management (RCM) partner. This discussion offered practical lessons that apply directly to IEPC member groups navigating today’s increasingly complex reimbursement environment.
While cost is often the first factor considered, speakers emphasized that the strongest RCM partnerships are built on transparency, shared goals, and consistent communication. For independent California groups, choosing an RCM partner that understands local payer patterns and the state’s regulatory environment is particularly critical.
Key Takeaways and Lessons Learned:
- Elevate communication and responsiveness.
Regular, structured communication with your RCM company is one of the clearest indicators of success. Look for a partner that provides a dedicated point of contact and consistent performance reports. Responsiveness is especially important when payer or coding issues arise that can delay payments. - Prioritize long-term partnership over short-term cost savings.
Selecting an RCM company should be approached as a strategic decision, not just a financial one. The best partners operate as an extension of your practice, invested in your long-term success, not only immediate collections. This type of alignment leads to higher overall performance and stability. - Define and track key performance metrics.
Before implementation, establish clear KPIs such as days in accounts receivable, denial rates, and first-pass resolution rates. Review these regularly to identify trends and improvement opportunities early. Data transparency and consistent benchmarking are essential for accountability. - Limit the number of vendors when possible.
Working with multiple RCM vendors may seem appealing, but can complicate reporting, increase costs, and blur accountability. For smaller or mid-sized independent groups, a single partner with strong alignment and reporting systems typically yields more consistent results. - Expect challenges and plan for change.
Every RCM transition brings challenges, from payer policy shifts to EHR integrations. A reliable partner will anticipate issues, communicate proactively, and problem-solve collaboratively to prevent small issues from becoming major disruptions.
The discussion reinforced that the foundation of a successful RCM relationship is trust, transparency, and shared accountability. For IEPC member groups, especially those operating independently, these principles can make the difference between short-term financial strain and long-term sustainability.