What finance leaders should expect from a partner when results fall short, problems recur, and business priorities change.
Your revenue cycle partner delivers the monthly report. Collections missed the target. Follow-up volume increased. Aged receivables grew. The explanation cites payer delays and a more complex account mix.
Those factors deserve attention. They also leave several questions unanswered. Which payers? Which accounts? What changed? What is the team doing about it?
A useful performance review connects the numbers to the work behind them. It gives you enough detail to judge the response, make decisions, and hold the right people accountable.
Here are five things your partner should be able to explain.
1. Why performance changed
"Payer delays" or "missing authorization" gives a performance review somewhere to start. It does not say what happened. Your partner should explain what sits behind the label.
Ron Anderson's perspective on denial prevention examined how "missing authorization" can describe several different failures: the team never requested authorization, the procedure changed after approval, or the approved information never reached billing. Each failure calls for a different response.
When results change, the team should investigate the affected payers, services, locations, and accounts to find the cause. Did a payer change its requirements? Did an internal process fail? Did the account mix shift?
The explanation should separate confirmed findings from open questions. If the cause remains uncertain, your partner should say what evidence the team needs and when you can expect an answer.
Ask your partner to name the payers, services, and accounts behind your last miss, and to mark which findings are confirmed.
2. Where work is waiting and who owns the next step
An account can receive several touches without moving closer to payment. A follow-up call confirms the payer needs a medical record. Someone logs the request. The account returns to a queue while another team locates the document.
A productivity report counts the completed call. It leaves the delay between teams out of view.
Our Sid Mehta described connected operations as an operating discipline. Each team sees the work around it, and someone owns every issue crossing a department or a partner.
Your partner should be able to explain what the account needs next, who owns the action, and how long it has waited. When resolution requires another department or partner, the team should describe how it coordinates the response and escalates delays.
Ask your partner to trace a stalled account across those boundaries. The trace should show where progress stopped and who will get it moving again.
3. What keeps causing the same problem
A successful appeal recovers revenue on one claim. Recurring denials point to the process producing them.
Shelley Badilla's article on year-end payer changes showed how a single documentation update can create months of rework when it fails to reach every affected team. Staff keep appealing denied claims while new claims enter the same workflow.
Your partner should explain how it spots these patterns and turns findings into corrective action. What changed? Which services and accounts does it affect? Does the response call for a workflow correction, a payer conversation, or a contract review?
Each agreed action needs an owner and a target date. The team should also track whether new claims keep hitting the same issue. The next affected claim should benefit from what the team learned.
4. How the partnership keeps pace with your business
Priorities shift. A physician group adds locations. A hospital expands a service line. An acquisition brings new systems and processes into the operation.
Each change reshapes RCM work.
Kumar Shwetabh described the move from service delivery to business outcomes as a partnership keeping pace with the client's business. It takes regular conversations about financial pressure, growth plans, and operational constraints, followed by specific changes to the work.
Ask your partner how your current priorities shaped its recommendations. Where would more expertise, a workflow change, or automation support your goals? What needs to happen first, and how will you judge the result?
A useful answer ties each recommendation to a priority you recognize and a result you can evaluate.
5. How the team will know the fix worked?
A correction deserves a follow-up measure. Completing a training session, changing a rule, or introducing automation records an action taken. The next review needs evidence of its effect.
If the team changes an authorization process, it should examine the claims following the change. If it clears a backlog, it should track whether new inventory builds. If automation shortens handling time, it should also check accuracy, exceptions, and repeat work.
Your RCM partner should agree with you on the measure, the review period, and what counts as improvement. When results fall short, the team should explain what it learned and how it will adjust the response.
At Access Healthcare, revenue cycle specialists and technology work together inside connected workflows, and we measure delivery against agreed service levels and outcome measures. Hold us, and every other partner you work with, to the same five.
At your next performance review, choose one result requiring attention and work through all five. You should leave knowing what happened, who owns the response, and when you will see evidence of progress.
About Access Healthcare
Established in 2011, Access Healthcare remains at the forefront of healthcare management, allowing healthcare organizations to focus on what matters most: their patients. As a global leader, we are recognized as a trusted partner by healthcare organizations, offering a combined AI-embedded, automation, and human expertise revenue cycle management (RCM) operating model to drive visible results at scale.