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RFP, RFI, or RFQ. Anyway you spell it...

in  RFP    RFI    FRQ    billing services  

Technically speaking, they're different. The Humboldt State University's IT Services website explains the differences between them, if you care. That long questionnaire designed to help leaders find a new vendor or business partner, etc. by any other name can still be a pain in the neck. Call it an RFP, RFI, or RFQ, - what really matters is what you get from it. For the purposes of this article, let's just use RFP, or Request for Proposal. As one who sees their fair share of RFPs, I want to offer a few ideas and suggestions for creating an RCM services RFP that will yield the information practices need to begin the selection process.

What to expect from your RFP
A good RFP is a lot like a resume in that it should help your company decide which candidates are worthy of an interview. When practices try to create an RFP that replaces the interview, the RFP can quickly become overly specific, redundant, and unwieldy - wasting both the practice's, and the responding vendors' time. Too often, we see RFPs that read as if they were cut from a dozen internet sources and haphazardly pasted together without much regard for the purpose of the questions. The cut and paste method may save some time up front, but it is sure to waste your candidates' time and ultimately yours, as you sift through a mountain of information you didn't really want or need.

RFPDifferentiate between your wants and requirements
Know what you require in your RCM partner relationship, and focus on questions that will give you the information you need. Describe any rigid requirements (In other words, "If you can't do this, don't even bother.") If there are deal breakers, identify them and make them clear to prospective candidates. For example, if you require your RCM partner use your current billing system, state that up front and save everyone some time and disappointment.

Know what your questions mean
It may sound laughable, but it's not uncommon for vendors wading through cut and pasted, or third-party sourced RFPs to ask for clarification on a question, only to find that the practice has no idea what the question is asking. Assume your vendor understands language and terms common to our industry - that's fair and reasonable. But, using language specific to your in-house systems or software vendors will likely generate unhelpful answers. Additionally, be careful to ask questions the candidates can answer. If you asking candidates to provide their fees in the RFP, make sure you are providing the statistical information necessary for the calculation. Similarly, asking for the cost of an interface to your EHR creates an impossible task if the candidates don't know what the EHR is, or the scope of the project.

Format and categorize
Think about how you want the answers you seek presented. If you are looking for a chart, say so. The same goes for layout, fonts and other format related items. Would you like the original questions repeated in the response document, or responses only? Categorize and group question by content.

Below is a suggested format. Not every line item will apply in your case, so eat the nuts and toss the shells.

Introduction and Overview.

  • Brief Project Overview - Introduce your organization and the purpose of the RFP
  • Describe deliverables
  • Describe the ideal candidate
  • Describe any rigid requirements (In other words, "If you can't do this, don't even bother.")
  • Format for RFP delivery
  • Timeline
  • Point of contact information
  • Provide revenue data (by specialty, if applicable)
    • Av. Monthly Gross charges
    • Av. Monthly Net receipts
    • Av. Monthly CPTs billed.
    • Av. Monthly Patient Encounters
    • Payor Mix
    • Service Mix (if applicable)

Vendor Candidate Profile
Keep this section brief and limited. Unless you really need to see the candidate's organization chart, don't ask for it. Focus on those areas that tell you something about vendors' experience and reliability and not on details you can get from the candidate's website.

Policies, Procedures, and Best Practices
This is where you will include the nuts and bolts questions about how the sausage is made. Ask "please describe" questions as they will reveal what the candidate values most in their operations and work flow.

Reporting and Decision Support
By keeping the questions general, you create latitude in answers. The result will be finding out what reporting metrics and analysis points are important to the vendor, and the extent to which they are engaged in understanding new reimbursement models. Ask for report samples, and to what extent you, the client, will be able to generate your own data and reports.

Knowing the computing platform, or what electronic claims clearinghouse the candidate uses isn't nearly as important as how the vendor will use technology to solve problems you have. Ask about their experience in writing interfaces. Again, "please describe" questions will be the most revealing.

Customer Relationship Practices
During the RFP and search process, everyone is putting their best foot forward. The big question is, "How will this relationship work when the honeymoon is over?" You don't need to ask for the names of your charge entry account specialists. Instead, ask about the candidates' views on conflict resolution and problem solving. In any long-term business relationship, failed expectations, perceived or otherwise are a reality. You want to know how your business partner will work with you to overcome problems and move forward.

Ancillary Services
Even if you enjoy a comprehensive provider credentialing and enrollment department, you may not always. Be sure to ask about services other than core billing. The best RCM companies understand they must provide a host of practice management services, not just billing.

Appendices (click the link below to receive this information)

  • Agreement
  • BSA
  • Report Samples

Remember, a good RFP should give you the information you need to begin the selection process. Spend a little time up front and you might save yourself significant time and effort later.

To receive a free Sample RFP from The Billing Pros, click here.



Cvikota Medical Business Services is also affiliated with Cvikota EMS Ambulance Billing Professionals, as well as our website development division, Webteam, Inc. Cvikota MBS serves clients nation-wide, with offices in Wisconsin and Tennessee.

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