The decision to outsource your revenue cycle management (RCM) functions can be stressful and complicated, impacting staff, patient flow, and, ultimately the bottom line. RCM, including medical coding, medical billing, A/R’s, and insurance discovery, have always required specific skills and knowledge set. But with significant bottom-line pressure from shrinking margins and changing payment structures, it has become critical to explore the benefits gained by streamlining the reimbursement process.

If you are currently using a third-party RCM partner in some component of the healthcare payment lifecycle, now may be the time to broaden their scope and scrutinize the level of technical support they are offering. Today, an external partner’s role should be automated and streamlined while also leveraging technology’s benefits.

What are the Benefits of Outsourcing Revenue Cycle Management?

Outside of providing patient care, the healthcare payment lifecycle is arguably the most important activity in any practice or hospital. Understanding the intricacies is complex and staying current, a constant challenge. Here are several operational complications that can be positively addressed when partnering with an outside vendor.

1. Finding Highly Trained Specialists

When you partner with an outside group, you are purchasing the skills and the know-how of a specialized team dedicated to providing you with the highest quality of billing and coding services. You can expect that they have the latest knowledge and training in their field of expertise and use it to maximize your reimbursement and in-depth knowledge of each insurance carrier and their latest updates and changes.

2. Ability to Gain Economies of Scale

It is always difficult to anticipate resource and staffing needs when business levels change, but you no longer have that concern with an outsourced solution. It will be up to the outside organization to scale up or down based on their clients’ needs. The savings and efficiencies are passed onto you without the headache of day-to-day human resources issues.

3. Transparency and Follow-Up

A RCM partner is compensated on amounts collected and is highly motivated to code correctly to avoid denials and rejections, and submit clean claims and to collect your amounts outstanding in a timely manner. Equally, they are interested in investigating and resubmitting outlier claims quickly to add to your bottom line (and theirs).

How Can Outsourcing Revenue Cycle Management Improve My Bottom Line?

Ultimately, the goal is to capture the maximum revenue for the service provided within the contractual agreements held between your practice or hospital and the insurance carriers. By utilizing a third-party partner, you gain the following:

  • Effectively Steering Through a Changing Reimbursement Landscape—With rules and requirements in constant flux, you can reduce the administrative challenge of navigating the billing and coding process and the A/Rs and rely on expert support for your reimbursement activities.

  • Consistency—In-house billing is susceptible to revenue disruption from unplanned staff changes. With an outsourced service, you are less vulnerable to cash flow interruptions.

  • Faster Reimbursement—Your bottom line is dependent on smooth, accurate processing of the various components of revenue cycle management. Using a professional third-party company will maximize your reimbursement achieving the highest amounts possible quickly.

By contracting with a strong outsourced revenue cycle management service, claims can be coded accurately to their highest level and submitted and followed up more swiftly, directly impacting your bottom line. However, the real value to you and your practice or hospital will be the ability to focus on what you do best—patient care!

Contact Infinx to learn more about improving your bottom line using our technology, and experienced billing specialists.