Outsourcing Revenue Cycle Management

Healthcare costs are skyrocketing. Patient debt collections and payer reimbursements are plummeting, and many providers are facing financial crises — or failing altogether. In healthcare, a healthy revenue cycle is crucial to cash flow. Outsourcing revenue cycle management (RCM) adds an expense, but the benefits of third-party expertise, technology, and dedicated service can mean the difference between a healthcare organization’s success and its financial failure.

Why outsource your RCM?

RCM is a crucial healthcare process that connects the clinical and administrative sides of healthcare from patient registration to final payment, but it’s often riddled with inefficiency. With insurance changes, government programs, constantly changing rules and regulations, new technology, and more, RCM is an increasingly complicated mess.

Traditionally, in-house administrative and billing personnel managed RCM. Outsourcing RCM delegates all its associated tasks to a third-party expert, freeing up your staff for other work. Professional RCM companies provide the following benefits:

  • Expertise, updated technology, and compliance with HIPAA and other regulations.

  • Accuracy standards make for fewer mistakes, which leads to fewer denials and faster payments.

  • Efficiency, reimbursement optimization, and typically, reduced overall costs.

What to expect

Not every RCM company provides the same services, and different health organizations require different RCM service levels. Some organizations need full services — everything from intake through final bill resolution. Others may only need billing or coding services. You’ll need to determine which services are appropriate for your organization and find an outsourcing company to match your needs. Take the time to thoroughly research potential outsourcing partners, and as with most services, remember, you get what you pay for — in both quantity and quality of service.

Outsourcing tips

If you decide outsourcing RCM is the right move, consider the following tips to optimize your experience.

  • Perform your due diligence, and vet RCM vendors properly.

  • Find the right fit. Look for an RCM company whose values align with your own.

  • Look for scalability to match your organization’s goals for growth.

  • Prioritize vendor accountability for successful revenue cycle outsourcing.

  • Give the vendor a stake in a successful RCM outcome.

Outsourcing your RCM may be just what the doctor ordered to increase your facility’s profitability and administrative efficiency.

To learn more about RCM outsourcing, contact Healthcare Resource Group.