Requirements Questions

RCM/PM
Describe how to manage the management and update of the various components: Fee Schedules, Appointment
Types, Providers, Code sets (include all you support), Master Schedules, Location Management (Billing,
Scheduling, etc.).
Please provide details on how your proposed solution provides targeted and measurable metrics for the
following areas: Clean Claim Rates, Collections/percent of billable, days in AR, Bad Debt/Allowable, Denial
percentages
Please provide details and samples on workflows to demonstrate system functionality and interoperability for:
Front Desk, Check out, Referrals, Eligibility verification, Call Center/Scheduling, Payment Posting, Claim
processing, Billing worklists/edits, and any other standard workflows included in your proposed solution.
Please detail any 3rd party applications required to perform full cycle Revenue or Patient Management. (i.e.
Optum, Clearinghouse(s), Eligibility tools, etc.)
Please describe how your RCM/PM proposal is integrated with the HER in your proposed solution. (Include
specifics on single/separate databases, partial or full integration, any outsourced or non integrated
functionality)
Does your proposed solution have the ability to process Credit Card Payments? IF so is it a PCI certified system
and at what level of certification?
Does your proposed solution have the ability to integrate with Precision BI/Origin Analytics tool? IF not what is
your available or your implemented solution with other vendors?
How does your proposed solution handle Merchant Banking reconciliation? Please include details on the
reporting available.
Does your proposed solution have full integration with charging from source systems outside of your proposed
solution (i.e. MHHS- Cerner and HHS-Epic). Please describe how these are achieved (i.e. batch or real-time
included in description)
Please provide clear demonstration of highly interfaceable solution with defined accountabilities between UT
Physicians and partner for interface development and implementation.
Do you have a clear understanding of the impact on transition from our legacy solution to your proposed
solution as it relates to direct impact to revenue stream? If so do you have metrics to enable UTP to mitigate
risks and plan for impact accordingly?
Please provide details on your proposed solutions cash handling/Management processes.
Does your proposed solution allow for UTP to maintain it's own deposits into a UTP account/lockbox? If allows,
how will UTP interface this data back to your solution?
Please provide a list of all standard RCM/PM reports and the availability of any ad/hoc reports
Does your system have the ability to create reports/extracts to PeopleSoft for draft journal entries? And can
these be scheduled to run automatically by schedules?
Does your system have the following reports available at the end of each month end close?
Gross Charges, Gross Collections, Refunds, RVUs by provider and by department
Gross charges, gross collections, and refunds by department by entity (MSRDP General and Harris Health)
and by FSC (Medicaid, Medicare, Managed Care, Indigent, Commercial, Self Pay, and other)
Rolling average twelve month collection rate (calculated using net collections as they relate to the month
the charge was generated) for the overall activity, by major FSC, and by entity.
Gross A/R by entity by major FSC and by aging bucket.

Can your system provide reports for the following by each Fiscal Year End and quarter:
Amount of adjustments/write-offs by code/type per month of charge.
Amount of bad debt estimated to be unsponsored charity care.
Analysis of charge lag: Review dates of service compared to invoice creation dates.
Charges and net collections by location categorized as either inpatient or outpatient services.
Does the system provide A/R stratification of invoice reports ad hoc or at structured periods and are they
configurable?
Does the system have quarterly and Fiscal Year End reports for the following:
Amount of adjustments/write offs by code/type per month of charge
Amount of bad debt estimated to be unsponsored charity care.
Analysis of charge lag: Review dates of service compared to invoice creation dates
Charges and net collections by location categorized as either inpatient or outpatient services.
Do you provide any services in the realm of managed care contracting? Do you have modules or functionality
that address this area of need?

RCM Questionnaire

Response