Managing the financial aspects of patient care has become an increased challenge in today’s healthcare landscape. The entire process of managing claims processing, from payment collection to revenue generation for healthcare providers, is covered by revenue cycle management (RCM). Many healthcare organizations are turning to revenue cycle management outsourcing as a strategic solution to mounting pressure and to reduce the overall costs.
This decision of outsourcing revenue cycle management (RCM) shows a significant shift in how healthcare providers are approaching their financial operations. Many providers are discovering the benefits of partnering with specialized RCM companies rather than keeping large in-house teams or investing in costly RCM softwares.
Here are 10 strong reasons why outsourcing your revenue cycle management could be the game-changing decision your organization needs.
Reasons Why You Should Outsource Revenue Cycle Management (RCM)
Reduction in Operational Cost
A huge reduction in the operational cost of RCM is one of the most immediate and tangible benefits of its outsourcing. To have an in-house RCM department, there needs to be huge investments in personnel, training, technology infrastructure as well as additional software licensing fees. These fixed costs are eliminated and converted into variable expenses when the RCM department is outsourced.
On average, healthcare organizations see cost savings of 20% to 40% when they transition from an in-house RCM department to outsourced solutions. These are the savings that come from reduced staffing costs, eliminated training expenses and most importantly saves the cost of overly costly software licensing fees.
Specialized Expertise in Advanced Technology
Outsourcing the work of managing the revenue cycle straightaway offers the use of the most advanced technology and specialized expertise that would be beyond the in-house reach for development. Professional organizations work in the management of revenue cycles and invest heavily in the modern revenue cycle management solution, artificial intelligence tools, and automation devices that do work with the entire process from registration of the patient to final payment collection.
These specialized organizations have teams of experts who understand the process of medical billing, coding regulations, insurance requirements, and compliance standards. Their expertise spans across many specialties and payer types, assuring that your revenue cycle management (RCM) is up to date with industry news on best practices.
Improved Cash Flow and Faster Collections
The outsourcing of revenue cycle handling witnesses tremendous variance in terms of cash flow timings and collection rates. The RCM experts have established relationships with the largest insurance firms, thereby assisting with insight into the specific requirements and procedures that would hasten the approval and payment of claims.
The cash flow has been made more effective in these organizations due to their complex systems of tracking and follow-up mechanisms. Further, RCM companies are ingrained with denial management and appeals departments, resulting in fewer write-offs and improved collection ratios overall. By outsourcing revenue cycle management, many healthcare organizations see an improvement in accounts receivables (A/R) days by approximately 15 to 30 days.
Enhanced Compliance and Reduced Risk
The ever-changing regulatory requirements and compliance in the healthcare system go from HIPAA privacy rules to changing billing codes and compliance standards. Outsourcing revenue cycle management shifts the major compliance burden onto specialized firms that have made it their business to keep abreast of all relevant regulations.
Professional RCM companies keep a robust compliance program with regular audits and training of the entire staff to ensure compliance with all applicable rules and regulations. This lowers your organization’s risk of noncompliance, which may incur penalties and reputation loss. With outsourcing for revenue cycle management, the financial operations are conducted by compliance experts, giving peace of mind.
Scalability and Flexibility
Seasonal fluctuations, market competition, or unexpected events such as tornadoes and floods can naturally cause changes in patient volume for many healthcare organizations. The ongoing challenge remains to size the in-house RCM team large enough to meet peak volumes while at the same time turning slow during slower periods.
RCM outsourcing gives you the ability to ramp up or down to meet your exact needs. Professional RCM companies can quickly either ramp up or ramp down to provide steady service levels no matter the ups and downs of your business. This flexibility means a lot for growing practices with rapid changes in patient demographics or service offerings.
Focus on Core Healthcare Services
Among the many significant advantages of revenue cycle management (RCM) outsourcing is perhaps that internal resources can be redirected toward patient care and improvement of clinical excellence. Managing RCM in-house demands a large share of executive attention, staff oversight, and problem-solving considerations, all of which take the focus away from providing quality healthcare.
Outsourcing the revenue cycle management (RCM) function allows management to work on strategic initiatives such as adding new services, improving patient satisfaction, investing in medical technologies, and improving clinical outcomes. This improved focus on core competencies often translates into improved patient care and improved performance on the whole for the organization.
Access to Real-Time Analytics and Reporting
Most healthcare businesses can’t afford to build their own advanced analytics and reporting tools, but professional RCM companies can. These businesses put money into advanced business intelligence tools that help improve the performance of the revenue cycle by giving them real-time dashboards, precise performance measurements, and predictive analytics.
With outsourced RCM, healthcare providers can get detailed reports on important performance parameters like clean claim rates, denial rates, collection ratios, and payer performance measures. This level of awareness makes it possible to make decisions based on data and find ways to make processes better. The precise analytics also help with strategic planning by giving information about revenue trends, payer behavior patterns, and operational efficiency measures that would be hard to get with in-house systems.
Reduced Staff Turnover and Training Challenges
In the revenue cycle management industry, worker turnover rates are very high. In certain companies, more than 30% of billing and coding positions turn over every year.This frequent change makes it very hard to keep experienced people, requires a lot of money to train new staff all the time, and makes it hard for workers to remember what they learned, all of which can have a big effect on revenue cycle performance.
By outsourcing, you don’t have to worry about hiring, training, and keeping employees anymore because the RCM partner takes care of all of it. Professional RCM companies have set up training programs, career pathways, and pay structures that are competitive. These assists keep staff stable and experienced. This stability leads to better overall efficiency in revenue cycle processes, fewer mistakes, and more constant performance.
Extended Coverage and 24/7 Operations
Many RCM outsourcing partners work in more than one time zone and offer coverage that goes well beyond normal business hours. This longer operational window means that claims can be processed more quickly, payers can get answers more quickly, and billing problems can be solved more quickly, all of which can have a big effect on cash flow.
The 24/7 operational model is especially helpful for healthcare companies that have long hours, emergency departments, or operations in more than one location. Extended coverage makes sure that revenue cycle activities happen all the time. This cuts down on delays in submitting claims, speeds up posting payments, and keeps an eye on denial management operations all the time. This constant activity can lead to faster income generation and better overall financial success.
Enhanced Patient Financial Experience
Professional RCM enterprises usually provide better financial services for patients, which can greatly enhance the entire patient experience and boost collection rates. These services include clear cost estimates, flexible payment alternatives, online payment portals, and financial advisers that work only with patients and can explain how billing works and what payment options are available.
The better financial experience for patients makes it easier for them to understand their medical bills, cuts down on the time clinical personnel spend answering billing questions, and often leads to greater patient satisfaction levels. RCM companies also use modern payment technologies including text-to-pay alternatives, automatic payment plans, and integrated patient portal solutions to help patients understand and pay their medical costs. Better patient experiences usually mean faster payments, less bad debt, and greater relationships with patients.
Summary
Outsourcing revenue cycle management (RCM) is a strategic decision that can change the way healthcare organizations manage financial operations. RCM outsourcing offers many benefits, including immediate cost savings, improved cash flow and enhanced compliance. It also improves patient experience and enhances compliance.
In a complex healthcare environment, where regulations are constantly changing, technologies are advancing, and patient expectations are shifting, healthcare organizations need the expertise, technology and operational excellence that RCM experts can provide. RCM outsourcing can be a strategic decision that improves overall organization performance and allows healthcare providers to concentrate on their core competencies.
