Emergency Medicine Billing – 5 Things to Consider when Soliciting an RFP

The standard process for evaluating organizations you’re considering for a service should involve an obligatory request for proposal (RFP). This document, often submitted as part of a bidding process, requests proposals from potential suppliers.

In the Emergency Medicine space, it becomes increasingly difficult to ensure that one is receiving a thorough and effective RFP from prospective partners to ensure that all of your business’s needs are being met.

The fact remains that when it comes to Emergency Medicine Practices, like most organizations soliciting requests for bidding, if you’re not asking the right questions, the answers you receive may have little to no consequence and can lead to an unfavorable and potentially hostile business partnership.

At DuvaSawko (DS), we know that you must ask the right questions of your billing partner to get the answers that can truly have a positive impact on your business.

Our newest Blog Posting highlights SOME of the necessary questions that you should be asking of your billing partner and the reasons why these questions should be at the top of the list.

DS offers a comprehensive RFP Q&A system — one of the perks of being Founded and Operated by ED Physicians.

5 Questions for Emergency Medicine Billing RFPs

Without showing all our cards, here are the top 5 questions on an RFP that should be answered when considering a partner. These are a sampling of the 45 Questions available on our complete RFP list.

RFP Questionnaire 

#1. Provide A Company History Including Past And Current Ownership And Scope Of Services You Provide.

Asking your RFP provider for a company history lets you get a good idea of how long they have been in the field and allows you to vet them based on their experience. Finding out what their full scope of services are will help you determine if there are gaps for the services that your ED needs and allows you to compare them to other providers you may be looking at.

#2. Provide A Vision Of Future Emergency Medicine Reimbursement And Your Strategies For Providing Necessary Tools For Independent EM Groups To Be Successful.

When choosing a RFP provider, you want to make sure that you are partnering with someone who will contribute to your long-term strategic goals. Asking this question gives you a clear sense of their development roadmap and whether or not their technologies provide the necessary tools to meet your needs.

#3. Describe Your Company’s Approach For Measuring And Reporting To The Group Metrics Such As Merit-Based Incentive Payment System (MIPS).

You want to partner with an organization that will enable you to optimize your MIPS score through the use of well-established quality measure benchmarks and reporting mechanisms. You want to ascertain whether or not this partnership will yield bonuses, or penalties, on Medicare filings in ensuing years.

#4. Describe Your Company’s Compliance Plan And Identify Any CMS Or Health Plan Coding Audits That Have Had Negative Outcomes For Your Clients. Furthermore, If You Are The Revenue Cycle Management Provider Selected, Are You Willing To Provide A Copy Of Your Compliance Plan?

Over the years, compliance plans have played an integral role in the way health care providers conduct business as they ensure that providers practice within the four corners of the law. When choosing a business partner, you want to be certain that they have an established compliance plan aimed at reducing, preventing, and discouraging deceitful and improper conduct. Knowing this information will help you avoid costly lawsuits.

#5. In The Past 10 Years, Has Your Company, Its Parent, Or A Subsidiary Ever Been Investigated For Suspected Fraud And Abuse By Any Department Or Agency Of Any Federal Or State Government Agency Including But Not Limited To OIG, CMS, Recovery Audit Contractor, Etc.?

You want to determine that there are no outstanding issues or problems with the organization you are trying to do business with.

Conclusion

Without an RFP, it would be extremely difficult to discern the differences between a highly qualified candidate and one who is mediocre, at best. With Emergency Medicine billing, the devil is truly in the details, and the more you know, the better the long-term decision you will be making for your practice. To receive our entire list of “must ask” questions when considering a billing partner or to have the team at DuvaSawko submit an RFP to your organization, contact us today by email or by phone at 888-311-8760!

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