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What are the Benefits of Outsourcing RCM for a Healthcare Facility


The Healthcare industry is lacking behind in technology and bearing many significant losses due to this. Many hospitals in the USA have non-integrated business applications and systems that are increasing the workload and, at the same time, reducing the revenue.

Additionally, they suffer from accounts receivable management, which directly impacts the budget to run daily operations. Therefore, integrating automation in their systems may not straighten their financial health. Still, it will surely bring synergy in their work and save them time for other productive tasks.

To improve financial health, they must develop solid strategies and bear the cost of implementation or outsource all operations to a reliable company with ample expertise in their work.

Revenue Cycle Management Systems

The revenue cycle is the process by which a healthcare facility receives reimbursement for the services it provides. It starts when the patient places an appointment and ends after the patient clears all the due. As simple as it appears, patients billing is a complex process. Many factors are involved in making the revenue cycle a complicated process. Among other factors, changes in the contract, poorly trained staff in the collection department, and legislative orders are few.

RCM systems improve medical billing by integrating and automating the flow of information across various channels. But for managing this automated system, you need highly trained staff because untrained people will make errors and add to the complications of the overall revenue cycle. One way to get out of this issue is to outsource RCM operations.

There are many benefits of outsourcing RCM  system in the healthcare vicinity, such as:

Focus on Treating Patients

Billing and related administrative tasks consume a lot of effort and time. Outsourcing revenue cycle management helps the staff to focus their efforts on the core function of healthcare. But, unfortunately, handling revenue-related functions distract them from maintaining the high standards of patient care. After all, the priority for the healthcare facility is the well-being of the patients. Therefore, anything that is declining the standards of the treatment must be removed.

Manage Staff

After outsourcing RCM activities like billing, recovery, registrations, etc., you have plenty of time and other resources to spend on your employees to an expert company. It becomes easier for you to manage staff and train them. On the one hand, they will be free to execute the main functions of healthcare. On the other hand, they will improve their skills by learning new things that will benefit humanity.

Lower the Administrative Workload

Day-to-day billings, tedious paperwork, registration, appointments, etc., cause frustration in the administrative staff and waste hours every week. Moreover, they have to waste energy in learning new things, which is their domain, and this increases their stress which reflects in their work. By outsourcing the RCM process, administrative staff can concentrate on other functions and improve the hospital and managing staff.

Error Free Billing

When professional coders perform the RCM functions, the chances of errors are negligible. It is because they are experts in their field and experienced in their jobs. They work proactively on the problem before it arises. Even if some mistake occurs in the billing and other functions, they have critical problem-solving skills and technology to overcome it. It will improve your reputation among patients and insurance companies.

Timely Reimbursement

Their only function is related to billing and paperwork. Your RCM partner is working efficiently to keep your recoveries in line. From appointment scheduling to billing and reimbursement, they work smoothly according to the well-defined timeline to get you peace of mind. Moreover, they provide a comprehensive report of all the functions to get a real-time idea of total earnings.

Keep Up with Industry Upgrades

The medical codes and insurance policies keep on changing. It becomes challenging for the medical staff to keep pace with the evolution. The outsourcing partner has all the resources, including time to work on new codes and learn about new technology because their expertise lies. Your medical staff will never be able to perform in this field as a professional biller can. You will remain on the top of the industry by implementing new technology and time-consuming outsourcing functions.

Managing Compliance Regulations

When you try to do everything yourself, something remains incomplete, or the quality suffers. For instance, while managing revenues and other medical and administrative tasks, hospitals may ignore compliance issues. Ignorance of the rules and regulations set by the federal government result in heavy fines and settlements. On top of everything is the fact that these rules are not constant. Instead, keep on changing with time. And healthcare facilities have to keep pace with these changing regulations.

Another benefit of RCM outsourcing is that hospital management gets enough time to maintain regulatory compliance and save their vicinity from getting sealed or losing a medical license. A reliable RCM service provider also keeps you updated about the changing laws to help follow the changes proactively.

Settling Denials

Due to incomplete information, medical claims are refused by the insurance companies. As a result, healthcare providers have to face more difficulty finding the evidence and resubmitting the claims. However, when a medical billing company manages RCM, denial drops 3 to 3.5%. It is because most of the claims are verified the first time they are submitted.

Better Financial Performance

Having an in-house RCM system increases the overall expenditure of the hospital. To maintain and operate the system, you have to hire a team which increases salary expense. In addition, the technology upgrades and cost of implementing the whole procedure is another big spending that accumulates the overall overhead.

Outsourcing RCM will save these expenses and speed up the receivables collection process, increasing revenues. Moreover, your cash flow will improve with an innovative approach and advanced features by spending a fraction of the cost you will bear for a domestic RCM system.

Bottom Line

According to a report,” The U.S. RCM market size was valued at USD 120.7 billion in 2020 and is expected to grow at a compound annual growth rate (CAGR) of 11.2% from 2021 to 2028.” Since outsourcing RCM has already reached such a significant value, it’s time for you to get relief by utilizing this opportunity.

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