The “Ins and Outs” of Insourcing vs. Outsourcing Revenue Cycle Management: Part 2 – Selecting an Outsourcing Vendor and Contracting

The next important decision to make is partnering with the right vendor. With options to choose from, it can be difficult to narrow down your choices—each of them may have experience, a trustworthy team, and reliable services, but how do you know they are the best partner for you?

Your selected vendor will be your partner in optimally managing your revenue cycle. They need to be experienced and qualified in your service specialization and payer market. They need to be able to scale to handle your initial volume and match your growth with appropriate resource and skill levels. And finally, they need to actively engage with you through feedback, reports, and outreach at the frequency needed.

The three major vendor qualification areas are as follows:

The vendor needs to be able to demonstrate their qualifications in each of these areas and elements. That will come from interviews, references, and industry reputation.

There are multiple options for services and fee models. Vendors may not offer all services and fee options.

Once you have done your due diligence and negotiation, the service agreement should have at a minimum the following components:

  • Business Associate Agreement (BAA)
  • Non-Disclosure Agreement (NDA)
  • Statement of Work
  • Fees and Payment Terms
  • Term and Termination
  • Ownership of Materials
  • Warranties

We provide revenue cycle management outsourcing as well as revenue cycle effectiveness evaluation, regardless of agency management solution. Schedule a call with our experts today to start your evaluation, and make sure to register for “Selecting an Outsourcing Vendor and Contracting,” the corresponding session in our 3-part webinar series, “The “Ins and Outs” of Insourcing vs Outsourcing Revenue Cycle Management.”


The “Ins and Outs” of Insourcing vs. Outsourcing Revenue Cycle Management: Part 1 – Outsourcing Decision Impactors

The revenue cycle – the series of steps related to reimbursement for services that occur from intake to payment – is the lifeblood of any homecare or I/DD agency. You can provide the best client support with excellent outcomes and grow like a weed, but with the thin margins we experience today, your agency will struggle if you don’t collect almost 100% of the revenue to which you are entitled.