Revenue cycle management (RCM) seems simple on the surface, but it’s actually a massive undertaking for healthcare providers. When you consider the breadth of responsibility associated with billing, coding, claims submission, and payment collection, it’s evident RCM goes beyond just sending invoices and collecting revenue. This is why many providers choose to outsource the process to a reputable provider.
What’s keeping you from offloading the monumental responsibility of RCM onto a trusted partner? For most providers, it’s the misconception they’ll pay more or bring in less revenue. But the opposite is almost always true: outsourced RCM results in lower costs and better revenue.
What is outsourced RCM?
Outsourced revenue cycle management involves hiring a third-party service partner to manage your practice’s revenue cycle. This typically includes coding, billing, and collections, as well as more nuanced approaches to claims submission and rework for denied claims. Outsourcing RCM means handing over the administrative tasks of revenue cycle management to a specialist, enabling your practice to focus on providing quality patient care.
The benefits of outsourced RCM
Outsourcing your revenue cycle management offers incredible financial benefits. First and foremost, effective RCM leads to improved cash flow, revenue, and financial stability. By outsourcing, healthcare organizations can access specialized expertise and knowledge for increased revenue capture and decreased claim denials. An RCM partner can also ensure accuracy in coding and billing, which helps to reduce errors and improve claim acceptance metrics.
More revenue isn’t the only financial benefit. Outsourcing also creates cost savings for many practices via reduced staffing costs, eliminated training expenses, and lower technology costs.
How outsourced RCM pays for itself
The combination of increased revenue and cost savings can actually pay for the cost of outsourcing RCM. A cost-benefit analysis can help providers determine if outsourcing RCM is a viable option — and it often is.
Typically, smaller practices need the most help with their RCM. These practices also have less to invest in sophisticated software or in-house billing experts. Outsourcing offers a reliable avenue for RCM improvements without incurring costs these smaller practices don’t have the capital or cash flows to justify.
The time it takes for outsourced RCM to pay for itself can vary depending on the size of the practice, the number of claims billed, and the baseline for improvement. For instance, a practice struggling with high claim denial rates may see instant financial gain from a drop in denials.
Factors to consider when outsourcing RCM
Simply outsourcing RCM isn’t a solution in and of itself; your choice of RCM partner matters. Providers must consider several factors to choose the right vendor, including:
- The reputation and experience of the vendor. Research potential partners to confirm they have a proven track record of delivering quality RCM services.
- A robust, AI-backed technology and digital infrastructure. The vendor should have the necessary technology and infrastructure to provide efficient and accurate RCM services.
- A commitment to flexibility and security. Any potential partner should be able to tailor their services to the organization's specific needs without compromising data security.
Considering these factors can help providers choose a reputable vendor with the capabilities to not only meet their RCM needs but also improve the speed to return on investment (ROI) they see from the partnership.
Outsourcing is always a viable option
The numbers don’t lie. Outsourcing RCM services can have a significant impact on the financial health of a practice. By reducing staffing and technology costs — while improving revenue capture and accuracy in coding and billing — outsourced RCM pays for itself in both cost savings and ROI. Of course, providers must still make the smart choice to partner with a tried-and-true RCM expert like TruBridge.
Learn more about the benefits of outsourced RCM at trubridge.com.
