Healthcare Revenue Cycle Management Companies must ask 5 key questions before choosing to build or partner. Read our guide to learn more!
As Healthcare Revenue Cycle Management Companies Grow, So Do Client Expectations
In recent years, the healthcare system has undergone drastic changes, with patients facing higher deductibles and greater financial responsibility. This shift has led many healthcare providers to expect more from their Revenue Cycle Management (RCM) company than traditional claims processing and insurance follow-up. Patient communication, digital billing, payment plans, financing, collections, and reporting have become important parts of the overall experience.
For healthcare revenue cycle management companies, this raises a strategic question:
Should these capabilities be built internally or delivered by an established company with the technology and infrastructure in place?
While building additional patient billing, collection, and payment capabilities internally may make financial and operational sense and offer greater control over technology, it also requires significant resources beyond the initial development, such as:
- Compliance responsibilities
- Development costs
- Integrations
- Ongoing maintenance
- Opportunity costs
- Support requirements
For many healthcare revenue cycle management companies, partnering may offer a faster, more scalable path to expanding services. Instead of taking on the full responsibility for building and maintaining every solution themselves, they can focus on the revenue-cycle expertise that differentiates their business.
Before making that decision, consider these five questions:
1. What Will It Really Cost to Build – and maintain – the Technology?
Go Beyond the Initial Development Cost
The build-vs-partner decision should not look solely at upfront software development costs, but compare the Total Cost of Ownership (TCO). An internally developed patient billing and payment ecosystem requires ongoing investment and continuous enhancements that could include:
- Customer support
- EHR/PMS integrations
- Hosting and infrastructure
- New feature development
- Payment processing infrastructure
- Product management
- Reporting and analytics
- Security and compliance
- Software development
- Testing and quality assurance
- Updates and maintenance
Consider the Long-Term Cost
These costs can increase as requirements, regulations, payment methods, and patient expectations evolve. Partnering with an established organization shifts much of this ongoing operational burden to a specialized provider while maintaining access to expertise, infrastructure, cutting-edge technology, and innovation.
For healthcare revenue cycle management companies, understanding the TCO and evaluating the next budget cycle are critical components of strategic planning. Current data indicates that approximately 76% of organizations are now considering partnering with an established vendor rather than building software internally.
Technology is not a one-time investment, and once launched, the RCM company must assume responsibility for keeping it secure, reliable, compatible, and competitive with evolving client systems. A meaningful build-vs-partner analysis should ultimately evaluate the full lifecycle cost, potential risks, strategic value, and operational demands.
2. How Long Will it Take to Develop a Complete Solution?
Consider the Time to Market
Depending on the project scope and complexity, building a new feature set or platform may require significant time for development, integration, testing, and implementation. While an RCM Company is working on developing a complete solution, clients may already be looking for the following capabilities:
- Automated payment reminders
- Collections
- Mailed statements
- Email and text billing notifications
- Financing options
- Flexible payment plans
- In-office and online payments
- Patient billing communications
What Is the Opportunity Cost of Waiting?
While building healthcare software may seem like the best way to customize solutions for a customer, challenges such as technology risk, regulatory complexity, resource strain, and time-to-value strains may be difficult to overcome.
When healthcare revenue cycle management companies spend months or even years developing technology internally, they face massive financial, operational, and strategic risks. Existing clients could seek additional vendors, competitors may introduce similar capabilities sooner, and prospective clients may choose RCM partners that can quickly provide a more complete solution.
Partnering can shorten the path between identifying client needs and delivering a viable solution.
3. Is Building This Technology the Best Use of Our Resources?
Innovative technologies and data-driven strategies are reshaping how many healthcare revenue cycle management companies address administrative burden, claim denials, and patient dissatisfaction. To address these ongoing challenges, many companies are adopting Artificial Intelligence (AI), with clear patterns emerging in revenue cycle management. In a recent survey, 20% to 40% of companies reported being actively engaged with AI-enabled tools to enhance their RCM capabilities, with 70% to 90% of decision-makers planning to increase spending over the next three years.
With RCM companies already managing considerable responsibilities surrounding A/R, claims, client relationships, coding, denials, payer reimbursement, and revenue performance, they must consider not only the financial implications of this strategic decision, but also ask:
Does building patient billing and payment technology strengthen our core competitive advantage—or distract resources from it?
Strong evidence suggests that patient billing and payment technology is not necessarily a distraction from the core business, and it can reinforce an RCM company's competitive advantage in the following scenarios:
- Creates proprietary data/workflow advantages
- Improves the patient experience
- Increases collections
- Reduces administrative cost
When building the patient financial experience around the company's existing competitive advantage, it is crucial to determine whether another operational product is being offered or a differentiated capability is being established.
Consider the People Required
Technology does not have to be owned to deliver value to clients. Every developer, executive, and IT resource, and executive's hour dedicated to creating and maintaining new technology is an invaluable asset that cannot be spent elsewhere.
Partnering allows healthcare revenue cycle management companies to maintain focus on key areas where their expertise can expand current capabilities while providing the best experience for their clients.
4: Can We Keep Up with Integrations, Compliance, Security, and Changing Expectations?
The Work Doesn't End When the Product Launches
Once a product launches, it is crucial to maintain the infrastructure to ensure the healthcare billing and payment technology integrates seamlessly with ongoing financial transactions, healthcare data, patient communication, and multiple software systems.
Key priorities include:
- Evolving payment preferences
- HIPAA compliance
- New communication channels
- Payment security
- Reliable EHR and practice-management integrations
- Responsive client support
- Timely software updates
- Scalability
- System uptime and reliability
Don't Underestimate Integration Requirements
RCM companies must meet the demands of a broad range of different Electronic Health Records (EHRs) and practice management systems. Building the core technology is merely one piece of an intricate puzzle. It can often prove to be a major undertaking to ensure the technology works efficiently across a diverse client base.
With over 40% of healthcare providers now outsourcing RCM functions to improve cash flow and reduce operational expenses, choosing the right partner requires careful evaluation of technology capabilities, services, and proven outcomes.
5. Which Option Will Create More Long-Term Value for Our Clients—and Our Business?
The decision cannot simply be: Can we build it?” It should consider the client experience while evaluating which approach creates the greatest long-term value. When determining if a partnership is valuable, an RCM company needs to ask:
- Can it expand our service offerings?
- Will our clients benefit from greater capabilities through one relationship?
- Will the partnership reduce the need for clients to seek out additional vendors?
- How does it improve the patient financial experience?
- Will clients benefit from accelerated patient payments?
- How does the partnership strengthen client retention?
Evaluate the Business Opportunity
A strong technology partnership can also help healthcare revenue management cycle companies become more competitive without the need for developing an entirely new technology division.
The right partnership is not simply about outsourcing technology but becoming part of the RCM company's overall ongoing growth strategy. It can create opportunities to make current services more reliable, differentiate offerings, strengthen client relationships, and potentially create additional avenues for improved cash flow.
While there is not one universal answer for all organizations, RCM companies should carefully weigh the following factors before deciding:
- Internal resources
- Long-term client value
- Ongoing responsibilities
- Time to market
- Total investment
What to Look for in a Healthcare Revenue Cycle Technology Partner
When looking for a trusted RCM partner, it is crucial to ensure they have an extensive range of patient billing and payment capabilities. It is also imperative that the solutions they offer complement rather than compete with the RCM company's core services.
Other things to consider include:
- Patient-friendly payment experience
- Patient communication channels
- Reliable support and implementation
- Scalable technology
- Strong EHR/PMS connectivity
- Visibility and reporting
Partner With BillFlash to Expand Your Patient Billing Capabilities
BillFlash is a highly regarded technology partner for healthcare revenue cycle management companies that want to expand their solutions without having to build an entire infrastructure on their own.
With over 20 years of proven industry experience, we provide the following technology to support the entire patient financial journey:
- Patient Billing & Communication: Automated payment reminders, electronic billing notices, mailed statements with QR codes, pre-visit billing, and secure two-way messaging on the online patient portal.
- Patient Financing: FlexPay enables flexible financing options that allow the provider to get paid first while the patient pays over time.
- Patient Payments: In-office and online payments, self-service payment plans, automated payments, and stored payment methods are available through patient payment solutions.
- Integrated Collections: Cutting-edge healthcare collections capabilities designed specifically to help healthcare practices manage and recover outstanding patient balances through a more connected workflow.
- Technology & Integrations: Support for 100+ EHR and practice management system integrations helps healthcare revenue cycle management service providers work across a broad range of technology environments through RCM integrations.
The Partnership Advantage
Healthcare RCM companies can benefit from continuing to own the client relationship while delivering unparalleled revenue cycle management expertise.
At BillFlash, we provide the infrastructure and technology to help healthcare revenue cycle management companies expand their offerings, while offering the following advantages:
- All-in-one solutions for patient billing, payment, financing, and collections
- Bring more patient billing capabilities under one technology partner
- Competitive pricing for mailed statements
- Create additional revenue streams through commissions when clients add BillFlash services
- Get solutions to clients faster
- Make the product more competitive and valuable by expanding offerings without having to develop from scratch
- One vendor relationship
- Reduce maintenance and internal development demands
- Strengthen and retain client relationships
- Support clients across 100+ EHR/PMS integrations
- Transactional pricing for each BillFlash service (only pay for what you use)
You Don't Have to Build Everything to Deliver More
Healthcare revenue cycle management companies are currently facing increasing pressure to deliver advanced technology and more convenience to secure better financial outcomes for their clients.
However, expanding offerings does not necessarily require expanding your internal development operations. The right technology partnership enables RCM companies to deliver more capabilities and respond faster to client needs, strengthening your competitive position while keeping teams focused on what they do best!
Before deciding to build, ask what you are really gaining, assess the long-term costs, and determine whether an established partner could help you reach the same goal faster.
Do You Want to See How Billflash Can Complement Your RCM Services?
Contact us today to schedule a demo and explore our patient billing, collection, payment, and financing software. Discover how a partnership with BillFlash could help you deliver more value to the healthcare practices you serve.