Rethinking the vendor-client dynamic in healthcare RCM by prioritizing goals, trust, and tailored communication over automation alone.
By Nick DiGiovanni Jr.Introduction: The Missing Piece in RCM? A Real Conversation
In today’s revenue cycle environment, there’s no shortage of automation, analytics, or AI. Most vendors are equipped with the same bells and whistles — and if you’ve been in this industry long enough, you know the technology gap is shrinking fast. But despite all that innovation, I believe we’re still missing the mark. Why? Because we’ve stopped having the right conversations. Over my career in sales, client service, and leadership — including years at the American Collectors Association and now at Annuity Health — I’ve seen a recurring issue across the industry: we focus on what we do, not on what our clients need. We offer reports no one reads. We pitch services that don’t align with evolving goals. We assume continuity where there’s been turnover. And most importantly, we forget to ask the simplest, most powerful question: What’s most important to you right now? This article is a call to bring the relationship — and the client’s voice — back to the center of RCM. I’ll share the model I believe can break through commoditization, rebuild trust, and differentiate a partner from a vendor: structured, intentional check-ins, honest conversations about deliverables and economics, and communication that’s tailored not just to the account — but to the human being behind it.I. The Vendor Problem: Why Even Good Service Falls Flat
Most vendors in the RCM space sound the same. The technology is similar, the processes are similar, and the promises are almost identical. But service that looks good on paper can still fall flat when there’s no meaningful dialogue behind it.
Too often, clients tell us, “You never told me you handled that kind of work too.” And that’s on us.
We assume our value is self-evident, or that our capabilities are already understood. We let years go by without realigning around goals that have likely shifted with every leadership change. We stop asking questions and start relying on templated reports and processes that no longer serve.
Automation is a powerful tool, but it can also mask relationship atrophy. If we’re not careful, we trade efficiency for connection—and connection is where loyalty lives.
II. Beyond the Bells and Whistles: The Substance of Real Partnership
Technology doesn’t differentiate you. What does? Understanding what matters to the client today. Maximizing returns isn’t just about effort—it’s about strategy. Take aged small balance portfolios, for example. A client’s first instinct is often to expect every account to be worked equally. But the truth is, that approach isn’t always efficient—or effective. What matters is having a smart, intentional strategy for the portfolio as a whole. At Annuity, we make it a priority to walk clients through that strategy upfront, setting expectations early on to ensure shared clarity around the end goal. It’s not about one-size-fits-all—it’s about aligning effort with impact. And the only way to build real trust is by being transparent from the start. Most vendors are afraid that transparency will cost them the deal. I believe the opposite: when you demonstrate a deep understanding of your client’s goals and your own operational realities, you position yourself as a true partner.III. The Case for Structured Client Reviews
Here’s a simple idea with outsized impact: intentional check-ins, at the right cadence, focused on the right questions. Let’s say it’s the six-month mark in a new client engagement. That’s the perfect time to say, “Here’s what you told us was important. Here’s how we’ve performed. Are those still your top priorities? Has anything changed?” You’d be surprised how often the answer is yes. Leadership changes. Board directives shift. A new compliance concern emerges. And unless you ask, you’ll never know. These reviews aren’t about defending performance; they’re about reconnecting with purpose.IV. The Human Element: Customizing Communication by Personality and Culture
We’re in a people business—but we often treat our clients like checkboxes. Not every VP wants a monthly call. Some want only results. Others want a lunch every quarter. Some organizations can’t accept gifts or meals at all but expect philanthropic participation. The point is: the style of engagement matters just as much as the substance. Understanding personality, communication preference, and cultural context is key to building long-term connection. The more we know about the people we serve, the better we can serve them.V. The Cost of Commoditization: Why Cheap Isn’t Smart
RCM is becoming commoditized, and it’s hurting providers more than vendors.
When we compete on price alone, we lose the ability to invest in better outcomes. Consider this: if your contingency fee is cents on the dollar, that means most of every extra dollar collected goes directly back to the provider. That’s not a cost—that’s a return.
But providers often leave money on the table by choosing the lowest bidder. And vendors, eager to win the work, stop pushing back. It’s time to change the conversation: from “How cheap can we get it?” to “What are we actually leaving behind?”
VI. Rebuilding the Team Mindset
This shift can’t just happen at the leadership level. It has to be ingrained across the organization.
That means training our teams—sales, ops, and client service alike—to ask better questions, listen actively, and communicate clearly. Many of our people have never been exposed to this approach, but when they are, you can see the lightbulb go on.
It’s not revolutionary. It’s just human. And it works.
VII. Closing Thought: RCM Is Still a People Business
We can talk about platforms and pipelines all day. But the real differentiator in this industry is empathy.
Know your client’s goals. Know their personality. Know what’s changed.
And above all—don’t assume. Ask.
That’s where partnership starts. And in a commoditized world, it might just be the most disruptive thing you can do.