Revenue Cycle Management

Do’s and Don’ts while adopting RCM

By Shannon Fernandez, VP of Billing Services, Yakima Valley Farm Workers Clinic

You likely receive several vendor emails daily highlighting the latest products promising to increase cash and reduce revenue cycle FTEs. Sifting through the onslaught of vendor options can be overwhelming. Establishing a transparent, structured process from vendor vetting through implementation will set the foundation for successful implementation. The following five Do’s and Don’ts will assist in ensuring success.


1. Engage contract review/approval personnel early

The contract review process is often long and arduous. Often last-minute changes stall contract approvals and derail implementation timelines before the work begins. Therefore, before sending out the RFP, reach out to the teams who are part of the approval process (IT, Purchasing, Legal) to include their requirements. Require selected vendors, advancing to the second round, to provide contract templates. Engaging legal/contracting personnel to review vendor contract language during the RFP vetting process will identify potential showstoppers early in the process.

2. Send the RFP to a wide range of vendors

We recently went through the RFP process for claims processing vendors. We selected five vendors whom we thought would be interested in participating. Only three vendors responded, which weakened the process. To broaden your list of potential vendors, research which companies have demonstrated success with the technology you are considering.

3. Involve a cross-functional team in the vendor selection process

Pulling together a cross-functional team broadens organizational visibility into the project. Including downstream and upstream revenue cycle customers in the vendor selection process provides unique insight and leads to engagement in the implementation process.

4. Start organizational education early

Everyone has an opinion on the effectiveness of the revenue cycle function, from clinical operations to finance. Introducing new technology into the revenue cycle workstream will follow the same pattern, especially when there is competition for capital dollars. Therefore, it is essential to communicate to the organization early and often the benefits of the new technology not only to the revenue cycle workflow but also to the organization. Communicate the metrics chosen to measure the project’s value/outcome.

5. Remain involved throughout the entire implementation

Once the project is kicked off, SMEs are assigned, and the work is off and running, the executive sponsors often fade into the background. Remaining engaged on the progress is vital to ensure timelines are met and roadblocks are addressed promptly. Implementations often falter due to a lack of executive sponsor engagement.


1. Avoid the naysayers

Some will disagree with the need for the technology or the product selected. Do not avoid the naysayers; instead, give them a front-row seat by including them in the RFP/Vendor review process. Diverse opinions can lead to more effective procedures and aid in change management.

2. Forget about change management

Newton’s third law of motion, “for every action, there is an equal and opposite reaction,” seems to apply to organizational changes. If change management is not part of the implementation process, you will pay for it on the back end. As Brene Brown says, “Leaders must either invest a reasonable amount of time attending to fears and feelings or squander an unreasonable amount of time trying to manage ineffective and unproductive behavior.” Change management should address those fears and feelings that can negatively impact the project’s success.

3. Exclude front-line staff from workflow redesign

Oftentimes something will be missed during the planning phase, and worst-case scenario, crucial workflow issues are not identified until after implementation. Including front-line staff in the workflow redesign and planning phase increases the chances of a successful implementation. Front-line staff engagement assists with change management as well.

4. Underestimate implementation time

Pad your implementation date; things always come up. As the saying goes, under-promise and over-deliver. Projects that fail to meet their timelines suffer from increased scrutiny post-implementation. Despite success with the project, overcoming the initial failure to meet the deadline may be too much to overcome. Avoiding this pitfall allows the project to stand on the merits of the implementation.

5. Forget to broadcast the wins

People are inclined to share all the things that go wrong with implementations; it’s human nature. Broadcasting the wins is crucial to counter any bad press and highlight the success of the implementation team’s hard work. Tracking the project’s success beyond meeting timeline and budget targets is critical to the continued organizational adoption of the technology. My most successful implementations included reporting on the pre-established metrics for the entire year post go-live.

Selecting the proper metrics is essential. Choose metrics directly impacted by the new technology. Common expected benefits include fewer manual interventions, reduced denials, or increased cash collections. Be sure to set the metrics baseline before kicking off the project. Using an agreed-upon baseline sets the stage for reporting on the project’s success. You cannot overcommunicate to leadership and the revenue cycle team that the technology provided the promised improvements, which will build credibility for future projects.

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