What Ambulatory Providers Look for in Revenue Cycle Management Vendors

When outsourcing revenue cycle management services, ambulatory provider organizations want vendors that excel in communicating, have adequate expertise, and can successfully educate clients, a KLAS report found.

Ambulatory providers increasingly rely on EHR-associated and EHR-agnostic revenue cycle management vendors as staffing challenges persist and payer requirements constantly change.

R1 RCM, an EHR-agnostic firm, scored the highest on overall performance, receiving an 86.5 on a 100-point scale. Organizations with over 75 physicians were satisfied with R1 RCM’s value and noted its expertise in streamlining revenue cycle workflows and improving collection rates. Users also said the vendor partners with organizations to meet financial metrics and clearly communicates progress.

EHR-associated CompuGroup Medical received an 86.1 for overall performance. The vendor acquired eMDs in 2020, leading to increased satisfaction among clients. Respondents said the firm has knowledgeable client services teams and quick response times. Clients also feel they have a consistent point of contact who understands each claim’s value to the organization.

Organizations using CompuGroup Medical reported that the vendor frequently adapts to new timelines and understands expectations. Additionally, respondents said they appreciate the firm’s ability to educate clients on how to improve internal processes and submit clean claims, provide feedback on updating processes, and help billing managers navigate ICD code updates.

athenahealth, also EHR-associated, received an 83.1 for overall performance. Users highlighted the vendor’s industry knowledge and said they trust the firm to perform well with minimal oversight. Clients also said athenahealth consistently notifies billing personnel about coding changes and holds frequent meetings with clients to discuss which parts of claims processes are causing denials.

IKS Health is EHR-agnostic and placed fourth for overall performance with a score of 78.7. Most clients have 150 or more physicians. Respondents noted significant improvement in A/R days, but many said they wish the firm were more involved in helping develop a revenue cycle strategy. According to limited data results, IKS Health users said the firm’s client education can be reactive, but some noted that it is improving in this area.

The KLAS report shared additional feedback from ambulatory providers based on limited data. Access Healthcare users said the firm helps organizations save money by reducing FTEs, demonstrates quick turnaround on projects, and provides frequent progress reports.

Clients said Greenway Health does not communicate progress for important financial metrics. In addition, clients reported a difficult transition to the new offshore service model.

Provider organizations using National Medical Billing Services referenced challenges with staff turnover, unorganized management, and a lack of reporting, leading to untimely filings, higher-than-expected A/R days, and inaccurate reports. Additionally, users said they’d like more consistent communication to stay updated with changing payer requirements.