Top RCM Vendors for Revenue Integrity, Underpayment Services

A new KLAS report highlighted the top-performing revenue cycle management vendors that provide revenue integrity and underpayment services to healthcare organizations.

The report reflects data from 2020 to 2022 collected from healthcare professionals over the past 18 months. KLAS gathered feedback on client perceptions of their vendor, including satisfaction levels and the vendor’s ability to educate, help, and communicate with clients.

Healthcare organizations reported that they valued vendors that educated clients on how to improve internal processes and proactively prevent revenue leakage.

Revecore and Cloudmed received the highest scores for the impact of a firm’s proactive education on client success. On a scale of one to nine, Revecore received an eight, while Cloudmed received a 7.9, both of which were above the market average.

Respondents said that the vendors helped develop more effective collection processes by meeting with clients regularly and providing training for staff members.

Aspirion clients gave the vendor a 7.7 for providing proactive education, which is the market average.

On the other hand, TransUnion Healthcare received a low score of 6.9. Clients reported that the relationship with TransUnion felt more transactional than proactive. They also noted poorer staff quality from TransUnion over the last year.

The most commonly used revenue integrity and underpayment services varied for each revenue cycle management vendor.

For example, all of Aspirion’s clients used the vendor for denials management, with underpayment recovery following close behind. Most BESLER clients used the vendor for transfer DRG services, while Cloudmed was popular for underpayment recovery.

The majority of clients used Revecore for underpayment recovery as well. TransUnion, which has a heavier technology focus than the other vendors, was most commonly used for Medicare reimbursement assistance.

Most clients reported that their vendors exceeded expectations, except for TransUnion clients.

Between 60 and 70 percent of TransUnion clients reported that the vendor exceeded expectations, which was far below the market average. Meanwhile, more than 85 percent of clients said the same about the other vendors, with Aspirion ranking the highest.

Aspirion also had the highest overall satisfaction score. Clients were pleased with the vendor’s ability to overturn denials and collect lost or missing revenue, according to the KLAS report.

In addition, clients described the staff as highly knowledgeable and said Aspirion provides frequent updates and detailed notes. Respondents mentioned Aspirion’s strong legal expertise, reporting that each engagement includes a trained attorney.

BESLER and Revecore received overall satisfaction scores above the market average, while Cloudmed and TransUnion fell below the average.

Aspirion and BESLER both received an 8.6 out of nine for quality of staff and consultants. BESLER clients reported that the company helped bring in more revenue than expected and identified internal adjustments to prevent future missed revenue.

TransUnion received an eight for staff quality—the lowest score among the vendors.

For overall performance, Aspirion received the highest score for the first few months of 2022. BESLER and Revecore followed close behind, with both vendors seeing a score increase compared to 2021. Cloudmed and TransUnion received lower performance scores this year compared to last year, the report found.

Aspirion and Revecore clients were the most likely to recommend their vendors to others in 2022. Revecore’s client relationship has continued to improve since 2020, with organizations seeing the vendor as a collaborative partner instead of a services provider.

In contrast, clients have become less likely to recommend TransUnion over the last few years due to poor communication and low quality of work. However, most clients viewed TransUnion as a long-term partner, citing its competitive rates and willingness to work with clients on pricing.

According to the 2022 Best in KLAS report, Revecore and Aspirion received the highest scores for best overall performance from a complex claim vendor. TransUnion Healthcare received the top score for insurance discovery, while Cloudmed ranked the highest for robotic process automation.