R1 Denials Management Services Commentary
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Subject Expert
Mollie Hunt
Research Director
Commentary Summary
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User Commentary
Operations, Services
There is not much feedback or education around preventing future denials. The firm just works...
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Services, Value
R1 RCM is a little expensive in some sites. However, they go above and beyond around the charging...
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Relationship, Operations
We have had very good results in the space with executives, so they are very attentive. The firm...
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Operations
R1 RCM’s formatting is nonexistent to us. They report in our style and our metrics.
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Operations, Services
I'm comfortable with R1 RCM’s regular, day-to-day work. There have been some challenges. We always...
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Relationship, Operations, Services
The denials side has been going well, but there is a lack of reporting depth. The reports are not...
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Relationship
I don’t think the firm has ever helped us prevent a denial. They have the right knowledge, but they...
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Relationship, Services
We have regular meetings with R1 RCM, and they go over all the different reports and data that they...
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Operations
With R1 RCM, there are some appeals that seem to fall through the cracks that don't get followed up...
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Relationship, Services
R1 RCM is really good about doing regular reviews. They brought an opportunity to us through their...
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Operations, Services, Value
We worked with R1 RCM on a project where they helped us understand that our reimbursement would be...
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Relationship, Services
R1 RCM was very responsive and transparent, and they tried to stay engaged; I appreciated that. And...
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Relationship, Operations, Value
With some of the accounts that we gave R1 RCM, there was really only a prayer that they could...
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Relationship, Value
R1 RCM’s overturn rate was better than we expected. They were successful, and we are still getting...
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Relationship
Our R1 RCM client success manager is very involved, and they address my problems.
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Relationship, Services
R1 RCM has good reports, but I often have to ask for additional details. The firm gives us the root...
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Operations
R1 RCM overestimated what they would be able to successfully appeal for us. I don't think they took...
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Relationship
R1 RCM has had some different changes in leadership, and they have made a lot of improvements in...
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Relationship, Services
R1 RCM has gone above and beyond on the payer escalations. Most firms would say that they are there...
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Relationship, Services
R1 RCM has a pretty good overturn rate, and we have continued to enhance that with the process...
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Relationship
Working with R1 RCM takes some strong partnership and strong oversight because we need somebody who...
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Services
R1 RCM does exceed expectations, but they do not consistently exceed expectations. I have very high...
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Loyalty, Relationship
R1 RCM has lost a lot of folks of late. The handoff process is fine. We won't see the effect of it...
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Relationship, Services
R1 RCM is so tactically focused on denials management that they don't necessarily step up, look at...
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Relationship
In a realm where a lot of firms are not great, R1 RCM is better than the rest. When I give R1 RCM my...
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Relationship, Services
In terms of preventing denials in the future, I would say the firm is very adaptable. They will...
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Value
When we initially brought the firm in, they knocked things out of the park and brought in quite a...
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Relationship
The only challenge is that the firm has had some staff changes. A number of folks have left and...
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Relationship, Services
In the past with a number of coders, nurses, and other associates, we saw some really quality...
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Relationship, Services
We have created some more enhanced internal processes, and some of our initial issues have dwindled...
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Services
In terms of reporting, the only thing that I would say that could use improvement is the bucketing...
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Relationship
We met with another firm that does similar work, but what was unique was that that firm wouldn’t...
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Relationship, Operations
Things are going really well with R1 RCM's denials management services. The work they are doing is...
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Operations
We really haven't had trending meetings with R1 RCM yet, so I don't have a good indication of how...
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Operations
The only piece of the firm's services that I wouldn’t rate very high is our aged A/R bucket that R1...
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Operations
R1 RCM hasn’t quite developed their reporting for denials management. They meet with us sometimes to...
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Relationship
Our engagement with the firm has lessened recently, but that is just because we are trying to keep...
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Operations
The only issue that we have is not in the book-of-business work. It is more between their company...
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Relationship, Value
R1 RCM is definitely delivering on what they have promised. They have run at a very high overturn...
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Services
We occasionally get people who mess up our accounts. But R1 RCM is very attentive to that. So as...
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Relationship, Operations
R1 RCM is very successful at active A/R denials. We really appreciate their feedback on those, and...
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Loyalty, Operations
We decided to leave R1 RCM. As we grew and learned more about different denial populations, we were...
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Relationship, Operations
We would like more timely submissions, more timely follow-up, and more flexibility to follow our...
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Relationship, Operations
We had a particular payer that denied all of our appeals for a certain procedure, and our main...
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Relationship, Operations
When we first started working with the firm, we used to have a lot of executive contact; the people...
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Relationship, Services
When Cloudmed was acquired by R1 RCM, we noticed a dip in quality, and I don't know whether they...
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Relationship, Operations
R1 RCM’s reporting was fine. They worked with us to do their reporting. It was hard to get them to...
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Loyalty, Relationship
Things are going pretty well with R1 RCM. I would say they are meeting our expectations. I see our...
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Services
I don't know whether other companies do this, but R1 RCM prepares a presentation for me to present...
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Services
R1 RCM is one of our partners and resources for outsourcing, so as we flex our staffing needs, we...
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Relationship
We recently received some feedback from R1 RCM where they did some auditing and figured out some...
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Operations
R1 RCM’s inventory reports are good. They give us a status of where each account is at so that we...
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Relationship, Operations
We work with R1 RCM because we don't have the resources to do this work in-house. Some other...
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Relationship, Operations
A lot of times, R1 RCM doesn't use electronic resources to submit their appeals. They use snail mail...
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Relationship, Services
R1 RCM is trying because they meet with us and give us what we ask. I feel like some departments at...
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Relationship, Services
I only work with a couple of the R1 RCM representatives such as the contact people. The people I...
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Operations
I would recommend R1 RCM because they do take every single case and attempt to get it overturned....
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Relationship, Services
With R1 RCM, the reasons why cases aren't getting overturned need to be brought back to case...
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Relationship, Operations
R1 RCM could do a better job with their feedback for case management because that is where denials...
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Loyalty, Operations, Value
I don't know what our upper management is expecting with the overturn rate from R1 RCM. We don't...
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Relationship, Operations
R1 RCM doesn't do a lot of meetings or provide feedback. They have recently started planning more...
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Operations, Value
Sometimes we look at new technology like certain add-ons, and we contract the firm to help us with...
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Relationship, Services
When it comes to reporting, I would just like more consistency. We normally get status reports...
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Operations
There are certain times when the volume is high that we have to do follow-ups to check on the status...
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Relationship, Operations, Value
The department I'm in has had a relationship with the firm for many years now, and they were already...
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Relationship, Operations
What makes the firm’s staff so good is that they are just so forthcoming and helpful with their...
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Relationship, Services
R1 RCM has good knowledge. They are able to overturn quite a few of our accounts. They do tweaks...
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Relationship, Services
Some improvements could be made by R1 RCM’s leadership level, or the ones directly with the denials...
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Services
There may be times when the charges in our system don’t line up with the charges we sent out on a...
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Relationship, Services
My open-denials volume is something we have stressed numerous times, and it still continues to be an...
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Relationship
The team members R1 RCM employs are a mixture of onshore and offshore. R1 RCM needs to make sure...
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Services
When we get insurance correspondences, those correspondences get scanned into our EHR, and we don't...
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Relationship, Services
Cloudmed does really well from a reporting perspective. We have found other firms we use are not as...
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Relationship
There is definitely room for improvement with R1 RCM’s overturn rate of accounts, and we continue to...
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Relationship
Over the past year, we have employed the firm to assist us with our utilization management denials...
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Operations, Services
In following up on a high-dollar account, R1 RCM will allow the account to sit there until 45 days...
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Relationship
R1 RCM can definitely do better with preventing denials. They have done well by us working with...
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Relationship
If we know there is a payer issue, we can't help that. We just keep pushing on the payer. But if...
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Relationship, Value
Historically over the entire project, I would say R1 RCM avoids charging, but that is not based on a...
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Loyalty, Relationship
We have been with Cloudmed for a while on a denials project, and that means obviously we are happy...
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Relationship, Services
When we notice trends or issues and bring those forth at least once, our goal and expectation is...
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Relationship
R1 RCM is really a good partner. We have regular meetings with them. They bring us trends. When I...
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Services
R1 RCM could improve their report packaging. For the most part, the firm is our only denials...
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Relationship, Services
It would be helpful if R1 RCM actually worked in our system. Our other vendor has a work queue, and...
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Loyalty, Services
R1 RCM jumps on our high-dollar claims. In all fairness, we have a lot of denials because of our...
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Value
I would choose R1 RCM again. R1 RCM has a broad scope of skilled staff. They have nursing expertise....
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Relationship, Services
We have frequent calls with R1 RCM, and that is where I address any concerns or questions I have for...
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Relationship, Operations
R1 RCM is very good at filing appeals. They are good at that. They are really good at reporting as...
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Operations
One thing about R1 RCM is that they are going to appeal something, but sometimes they appeal things...
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Relationship, Services
R1 RCM could do better when we communicate changes or notice something that they aren't doing as...
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Operations
The only thing that R1 RCM needs improvement on would be certain processes in our workflow. The firm...
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Relationship, Services
R1 RCM does a pretty good job. We have frequent meetings where we can address any issues or concerns...
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Relationship
I don't know whether this is related to the many acquisitions that R1 RCM has gone through, but...
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Relationship, Services
R1 RCM is incredibly efficient. They have all of the in-house expertise needed to do an appeal. If...
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Relationship, Services
Overall, R1 RCM has been a really great partner for us in clinical appeals, and they are always...
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Relationship, Services
We don't use R1 RCM for our entire inventory, so they don't do analytics on the denials. They don't...
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Relationship, Operations
Getting to a place where we were comfortable and satisfied took a while, and that was only on R1...
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Services
R1 RCM gives root cause analysis for denials, and from there, we have to fix the problem in order to...
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Relationship
We meet with R1 RCM often, and they provide us with detailed findings and trends, so the engagement...
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Value
The recoveries that R1 RCM does are pretty much paying for the engagement. We have a contingent...
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