Nowadays, healthcare institutions find themselves bound to ever-changing regulatory specifications and dynamic market forces. All the while, they’re striving to deliver best-possible outcomes to their patients while still adding to their bottom lines and maintaining their own financial health. Financial stability goes a long way in allowing these institutions to operate at peak efficiency, which translates to a stronger, healthier community.
What we’re seeing now is a complex relationship between healthcare providers, patients and third-party payers working to maintain solvency. As costs continue to increase, so have the complexities of supporting reimbursement systems, changing the face of Revenue Cycle Management (hereafter: RCM).
Revenue cycle management (RCM) is currently undergoing an unprecedented transformation. The processes governing the flow of funds must be continuously streamlined and improved. Healthcare providers, insurers and the banks they work with will look to dexterous and innovative partners, like Oklahoma City-based RMS (Revenue Management Solutions), to revolutionize their electronic revenue management. With their proven workflow automation tools, they work directly with the HCP, providing tailored software solutions that work within the existing framework of their clients’ practice management systems.
Here are some of the insights RMS CEO Scott W. Thomas shared with us:
The Journey
Founded in 2006, RMS focused solely on paper-to-EDI conversion. We quickly grew beyond that. Now we’re working in every facet of the healthcare remittance processing and reconciliation process. Over the years, we began developing proprietary software for each of the audiences and sectors we serve. We don’t create off-the-shelf products or components because those kinds of products, offered by our competitors, can’t perform the service required in our niche and don’t operate at the standard to which we hold ourselves.
Today, more than half of our monthly transactional volume originates as EDI without ever being reduced to paper. Now, we’re not only able to ingest and process all remittance types (paper, EDI, secondary payments, online and return mail patient payments, etc.), we also turn that data into action, helping give our clients a more holistic view of their revenue cycle health. It’s these value-added services that continue to drive business our way.
We are currently focused on building out more analytics offerings and facilitating a stronger financial connection between providers and patients/guarantors. With better visibility into payment trends, we can work toward meaningfully reducing DSOs for healthcare providers.
Challenges Faced by RMS
I’ve said a thousand times: “We were either too tenacious or too stupid to quit.” We were privately funded and singularly focused on remittance. We had to succeed in this niche or the entire company was a failure. Driven by our commitment to investors and our own underlying belief in our team members, we continued to push forward and find success by delivering a solution that no one else can.
Turning Obstacles into Achievements
Building the technology platform was an arduous path. We didn’t anticipate having to build all of the individual components we have. As we encountered barriers, we looked at available options, and usually found none were suitable for our application. So, we would build our own solution. Now that we’ve delivered dozens of proprietary applications, we’re comfortably separated from the competition.
No one else has used technology to create scalable solutions like this. Where others simply employ offshore manual labor to capture data, we deliver a much more comprehensive solution and workflow. The real challenge now, however, is convincing potential customers to embrace the value-added services we can also provide, services that no one else can.
Distinctive Strategies & Services that Assure Success
Our success is based on a solid understanding of the issues our customers face. They just want someone to provide solutions to their daily struggles. Once we understand their challenges, we’re able to develop the solution that’s tailored to their needs.
We work with some of the nation’s most prestigious and advanced healthcare systems and provider groups, as well as some of the top healthcare banks in the country. We don’t have to predict the future, we just have to listen. Our clients and partners know what they need and what we’re positioned to offer them. All we must focus on is delivering what they ask for.
Innovations of RMS as Narrated by Scott
Our payment splitting and payment merging services are something we haven’t seen anyone else offer. Payment reconciliation tools and industry-leading data lift and match capabilities drive a layer of value that our perceived competitors are generally failing to provide.
“The Greatest Project”
As our platform continues to expand, choosing a single “great” project is tough. We performed a mass migration at one of the largest banks in the nation, a bank that had previously been working with a competitor solution. Migrating their portfolio of healthcare providers from their platform to ours was a huge success story, one that was only made possible through the committed focus on both our own team and the bank’s.
Growth Plans to Expand
Our growth has been extraordinary and, due to the success of our bank partners and their sales successes, continues to increase. We don’t see this slowing down at all as we continue to onboard new banks and other partners with significant distribution channels.
Key Elements for a Successful Customer Base and a Successful Business
Historically our customers have been banks, with the end users of our solution being the healthcare providers. We have to build strong relationships with both groups by understanding their needs and their perspectives in this continuum. The banks want to serve their healthcare clients with thorough subject matter expertise and meaningful solutions. We provide both without interfering with their existing customer relationship. For the healthcare provider, it comes down to an efficient service that becomes part of their daily workflow. Our solutions supplant a lot of labor costs and supplement their processes to maximize the expertise and time of their workforce.
The DNA of our team is focused on more subject matter expertise. This includes the Project Management, Account Management, Business Analysis, and Software Development, teams. By continuing to add depth to these groups, we are expanding our focus to lowering the technical and informational hurdles that come with implementation and service adoption.
Igniting the Future by Revolutionizing Data
While it sounds a bit cliché, people are what make our company great. There is a great commitment, pride in what we do and a driving desire for excellence that keeps us focused. As we expand our team, our sense of who we are and what helped us get here is always at the front of our minds.
While introducing himself, Scott Shared:
I have been in healthcare for my entire career and focused on technology solutions for more than 20 years now. Over time, I noticed a gap in innovation between the claims side of the revenue cycle and the remittance/payments side. Technology has been well-employed on the claims side and insurance companies have done an excellent job promoting market adoption of EDI there. The remittance and payments side continues to lag. We have built a platform that focuses on employing technology and business logic to improve this process, creating efficiencies that have been lacking for decades.
Golden Words by Scott for The Younger Generation Dreaming of Entrepreneurship
Building something from nothing is harder than it looks. A masterful idea isn’t enough. It requires resources, drive, commitment and an unwavering belief in the objective. There will be dozens, if not hundreds, of setbacks. Each one should be accepted as an obstacle, not a barrier. Surround yourself with people you trust, people who know they can trust you. The path will be difficult, but it’s certainly navigable.
Learning to set aside my timing expectations and accept that outcomes are more important than deadlines was probably one of the most difficult lessons for me. As an entrepreneur, I wanted the outcome and I wanted it on my schedule. Realizing and accepting that sometimes I couldn’t control the timing, but only stay the course until the result was achieved, was an invaluable lesson.
