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How well do you know your business partners?

Healthcare Business Review

Sarah Ginnetti, Chief Revenue Cycle Officer and Vice President of Clinical Revenue, UConn Health
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Having several business partners and outsourcing various pieces of your operation is in no short supply when it comes to running a top-performing revenue cycle.  What is less apparent, however, is how well you are managing those relationships.  From time to time, leaders fall prey to a false sense of security and adopt a “set it and forget it” philosophy.  In other words, once the partnership is in place, it’s the business partner’s responsibility to own the work and deliver results, right?  Not so fast.


Each partnership comes with a set of principles that revenue cycle leaders need to adhere to:


1.  Add a vendor liaison to your internal team.  Consider this person your dedicated vigilante.  The liaison should monitor files and activity on a daily or weekly basis at a minimum and should quickly escalate if process defects or potential issues are identified.  The longer you wait to address something, the longer the fix will take to remedy and the larger the fix.  Do not load this liaison role onto someone’s already full plate.  They will not succeed.  Repurpose a strong staff member whose load may be significantly reduced as a result of these business partnerships.


2.  Develop reconciliation files with your IT department.  Do not assume what the vendor returns to you is accurate.  Trust but verify using your data.  Reconcile inventory weekly and develop a process to validate performance and invoices, particularly when it is tied to revenue recovery.  The devil is in the details.


3.  Take your time with implementation.  Do not sign off on the implementation phase of any new partnership until 99% of your needs have been met.  Once you have migrated off implementation, it will be harder to have break/fix items addressed.


4.  Mandate meetings.  Hold monthly operational meetings with key stakeholders internally and those assigned to your account from the business partner as well as ensuring the business partner sets up Quarterly Business Reviews at the Executive level.  And be equally accountable for attending these meetings as the client.  Resist the urge to “blow them off” or skip a month because your impression is that everything is fine.  There is almost always something new to talk about each month.  Keeping both sides engaged, even if there are no major concerns, is critical.


Stay attuned to new potential business partners every 2-4 years, even if you are pleased with what you have today, to ensure that you are optimizing performance in each segment of your operation


5.  Remember you are playing the long game.  Anticipate that you will need to make changes to the process/file exchange/communication between organizations for most of the first 12 months post-implementation.  Certain program components are forgotten or do not always work as anticipated ahead of time, so you will need to make tweaks during this initial period and beyond.


6.  Have high expectations and communicate them clearly.  Be very clear in your expectations about the relationship.  Things will undoubtedly go wrong, and that cannot always be prevented.  Responsiveness is key, and it is a two-way street.  If you have brought concerns forward that have not been addressed after an unacceptable period, make sure your team is escalating those unresolved concerns up the chain.


7.  Ask for data that will be meaningful to you.  Most business partners have an out-of-the-box set of reports and dashboards each month, but these may not cover everything you need.   It may not tell you all you want to see.  Do not be afraid to ask them for more.  Nine times out of ten, the vendors can provide you with what you are looking for, if you just ask.


8.  Request an optimization assessment every 18-24 months.  This principle holds true, particularly if you are using software or technology provided by an outside organization.  Many times, we underutilize what we were offered.  If it is a service offering, make sure you are using and receiving all the services that were included as part of your contract.  You may be paying for components or services you didn’t even know you had.


9.  Data security is paramount.  Keep your IT security teams apprised and involved in all relationships where critical business data is being exchanged.  If the business partner has not been vetted by your IT security department, do a retrospective review of those partners you have in place who were not vetted at the time of implementation.


10.Talk to your colleagues.  Find out who else is using the same vendors and see if they are satisfied with their services. They might have discovered something that you haven’t yet. Ask them to share any insights or improvements they’ve made to enhance their partnership with the vendors.


In certain cases, there simply might be better partners out there for you if they are not delivering on several levels, despite your best attempt to keep them engaged.  Stay attuned to new potential business partners every 2-4 years, even if you are pleased with what you have today, to ensure that you are optimizing performance in each segment of your operation.  Some of the business partners you have today may have new functionality in their development pipeline but have failed to share their internal roadmap.


Remember the platinum principle above all else:  you are responsible for the performance of each business partner.  If they are underperforming, you are underperforming.  The reason for underperformance can be any combination of one or many of the principles above breaking down as well as other factors.  The buck stops with you as a leader, and you are ultimately accountable for either the success or the failure of each partnership.


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