Our Vendor Oversight & Optimization service ensures your outsourced partners—billing vendors, technology platforms, and third-party service providers—are performing at their highest potential and fully aligned with your organizational goals. We bring structure, accountability, and transparency to your vendor relationships, turning vendor management into a strategic advantage rather than a financial drain. 

Why Vendor Oversight Matters Now More Than Ever

Healthcare organizations often depend on multiple vendors—billing companies, coding partners, clearinghouses, and automation tools. When performance slips or data goes unverified, cash flow suffers.
PR360 ensures your vendors meet contractual commitments, achieve KPI targets, and stay aligned with your revenue-cycle strategy.

Vendor Performance Audits & Baseline Assessment

We start with a complete billing vendor audit that reviews:

• Contract terms vs. real-world execution
• Claim turnaround times and accuracy rates
• Denial and appeal performance by vendor
• Payment posting, reconciliation, and response SLAs
• Communication and escalation efficiency

Each vendor receives a quantified performance score and variance analysis against benchmarks.

SLA Governance & KPI Scorecards

We transform your vendor relationships into measurable partnerships.
Our governance framework defines clear performance metrics and reporting cadence, such as:

• Denial rate by vendor
• Clean-claim rate and first-pass yield
• Average days to resolve payer rejections
• Cash posting timeliness
• Ticket and escalation resolution times

All metrics are displayed in executive dashboards and reviewed in structured monthly or quarterly governance meetings.

Contract Optimization & Vendor Realignment

When audits reveal underperformance, we guide renegotiations or realignment.
We help you:

• Benchmark rates and service levels against market data
• Define penalties and incentives within vendor contracts
• Re-allocate scope among vendors to maximize efficiency
• Design “gainshare” models tied to actual results

This ensures your RCM vendor ecosystem operates like a true extension of your revenue team—not a black box.

Continuous Monitoring & Improvement Framework

Vendor oversight isn’t a one-time exercise—it’s an ongoing governance program.
We build monitoring dashboards and recurring review cadence (monthly / quarterly) to maintain accountability.
Each cycle concludes with action plans for improvement, KPI recalibration, and documented follow-ups.

Measurable Outcomes You Can Expect

Clients who implement structured vendor oversight typically achieve:

• 10–20 % faster cash posting
• 15 % reduction in vendor-caused denials
• Improved SLA adherence above 95 %
• Visibility into every contract deliverable and KPI trend