When it comes to running an efficient operation and ensuring full and prompt payments, even the best revenue cycle leaders and teams face significant challenges. In hundreds of conversations, RCM directors, managers, and staff have talked again and again about three big issues:
- Limited IT bandwidth
At most medical groups, IT’s most prominent stakeholders are the physicians and clinicians. From EHR latency and clinical application bugs to laptop and smartphone glitches, the medical staff’s issues and complaints always seem to come first and eat up most of IT’s time and attention.
This typically leaves RCM teams struggling to get their needs met. The IT people often don’t have time for activities such as implementing new revenue cycle applications or upgrading existing ones—let alone custom programming or rule/edit writing.
That’s why the most successful revenue cycle applications are those that require little or no IT involvement in day-to-day operations.
- Rigid vendor relationships
All too often, medical groups are sold a product or solution that simply doesn’t do everything the vendor promised it would do—or isn’t flexible enough to meet the group’s needs.
Unfortunately, this is especially true for foundational EHR and PM systems that medical groups rely on to serve their patients and get paid. Many vendors claim to have built applications that can meet every need of every client out of the box—regardless of special requirements and workflows.
But in reality, every medical group and its RCM team have unique requirements that demand flexible, adaptable, and customizable software solutions.
- Constantly changing payer requirements
It’s bad enough that payers all have different rules, procedures, and demands. Worse, payers often change their own requirements, sometimes with little warning. Spreadsheets, post-it notes, and team members’ memories just don’t cut it in the face of such rapidly shifting complexity.
RCM teams need a way to keep up with and meet the latest requirements of all their payers in real time.
How RCxRules helps you take control
Over the last eight years, our seasoned team has worked with a wide range of medical groups to help them gain more control over their revenue cycles and meet the demands of their most difficult payers.
In the process, we created the industry’s only truly predictive rules engine that empowers revenue cycle users to proactively build their own rules—and outsmart payers at their own game.
Imagine gaining payer insight and then writing a rule in minutes to permanently eliminate rework and denials related to that issue.
Our rules engine makes it easy to build complex rules that will help ensure that your claims meet all payer requirements—and that you’re paid appropriately and in a timely manner. We’ll work with you to write hundreds of specific payer + specialty + provider scenarios—and give you the ability to write your own rules and take control.
Here’s what some of our customers are saying:
- “I would recommend RCxRules, it’s exceeded our expectations. What we thought we could do with RCxRules early on has really morphed into so much more than what we expected. We’re constantly thinking of new rules that can streamline our process and make our revenue cycle better. RCxRules has been a life saver for us, we’re very happy.” -Tonya Weston, Coding & Insurance Manager, Mankato Clinic
- “When I think about RCxRules, I think about them more as a business partner rather than just a vendor, because they’ve really listened to us—what our business needs are and helped to configure our system to meet those needs.” -Chad Barringer, Director of Revenue Cycle Management, OrthoCarolina
- “The ease of use of RCxRules has made employees happier because it’s a simple system to work in. We can write rules so whether 10 charges or 100 charges come through, the scalability is there so we don’t need to increase FTE count.” -Chris Fay, Chief Information Officer, Physicians Resources LTD (PRL)
To learn more about what RCxRules can do for you and your team, contact us today.
