Revenue cycle management (RCM) is crucial to a healthcare organizations financial organization and success. By utilizing RCM’s medical billing software, providers can track the entirety of the patient care process, from registration to appointment scheduling and final payments. With the new age ICD-10 and a growing level of financial responsibility, many medical employees are working outside of their roles, and juggle administrative tasks such as billing, paperwork, and claims.
Outsourcing the management of an organizations revenue cycle to specialized experts can help buffer the challenges sparked by increased regulations, decreased reimbursement levels, and a growing patient populous. An affordable, adaptable strategy, outsourcing RCM can also alleviate the pressures and time shortages of healthcare employees, and help return their focus to genuine patient care. Here, we will further discuss the benefits of placing revenue responsibilities outside of your healthcare organization.
Benefits: Efficiency, Revenue, Focus
By outsourcing your organization’s revenue cycle management to professionals, you can increase the efficiency, and ultimately the revenue of your practice. With experts optimizing coding, reworking documentation processes, and monitoring denials and appeals, outsourcing RCM can reduce the time consumption and costs of administrative tasks, thus increasing a practice’s bottom line.
With outside assistance, an organization can also decrease employee stress level and revert focus back to patient care. The administrative roles that nurses, physicians, and other staff previously backed, such as measuring and managing the reimbursement and collection processes, can be better performed by an outsourced RCM expert. And with employees staying in their lane, patient retention will gradually increase, and billing submissions will be more timely. Therefore, resourcing an outside vendor to manage an organization revenue cycle will ultimately reduce administrative overhead, increase profit margins, and boost employee morale.
Choosing the Right RCM Vendor
Before hiring an RCM vendor, a facility should analyze its financial processes and consider a multitude of variables, including practice strategies, costs, experiences, and goals.
When interviewing prospective vendors, outline clear financial goals and collaborate to create a timeline. While it is possible to incorporate a vendor into a short-term RCM solution, it is generally more beneficial to establish a long-term partnership if a healthcare organization seeks to rewire its internal processes thoroughly. Regardless, RCM experts can assist or train internal management so that, in the future, they can regain control or co-manage the revenue cycle efficiently and strategically.
Is the cost worth the investment? This is the primary consideration when a debating an outsourced vendor. The answer is yes; the right professional can drastically benefit companies bottom line. However, investing in an inexperienced, more affordable vendor might not bring such a prominent return. A vendor should be able to prove that its RCM experts can obtain higher overall collections, outperform the cost of service, and help a healthcare institution reach its goals. Experts should also stay up-to-date with industry innovations and information, and be adaptable in the face of unexpected challenges. An inexperienced vendor, on the other hand, risks increasing debt or violating regulations, and reversely hurt an organizations revenue cycle.
Before outsourcing or hiring a vendor, an institution should map out the precise areas that require attention. Most vendors offer a set of core functionalities, as well as additional features that can integrate with clinical platforms. Healthcare facilities should identify which areas of their RCM platform need improvement or would benefit the most from outsourced services before choosing a vendor. Different facilities will invest differently, according to their overarching needs.
A healthcare facility should also be hyperaware of IT considerations when hiring a vendor. IT malfunctions, if left unaddressed, can be detrimental to RCM, employees, and the outsourced professional. Facilities should be aware of software features, proprietary technology, and performance transparency.
The healthcare industry is ever-changing, and so are the goals and strategies to manage revenue cycles efficiently. Alternative payment models are becoming more common, and clinical outcomes often affect reimbursements. These new revenue considerations, along with risk-based contracts, prove that some RCM components are difficult for a facility to control, and makes data monitoring increasingly important. The data can include population tracking, funds disbursements, and many other pieces of information.
Many vendors rely on proprietary IT technology in their RCM services. While it is understandable that vendors do not use cheaper, open source technology for the sake of patient privacy, internal staff requires training to use the technology efficiently. Vendors also play a large part in implementing their technology within a facility’s systems. Before the cohesion of different software, it is essential that a facility clarifies ownership rights to both the software and the data. Failing to clarify these rights could result in legal or regulatory violations.
Finally, when choosing an outsourced RCM system, a facility should be able to assess the status of the outsourced revenue cycle quickly and easily. This assessment must look at the entire cycle, including claims, accounts receivable balances, and backlogs. However it is provided, some use dashboards or reports, the assessment should be available in real time. Facilities must be confident that their systems are compatible with the vendor in order for these real-time functions to work correctly.
eReceivables is a reputable and trusted RCM vendor which offers a suite of solutions for all parts of the revenue cycle. Its cutting-edge software is available at a reasonable cost, and its solutions are customizable for the needs of healthcare facilities of any size. Starting with the package of core functions, which includes billing and claims management, facilities can add on many other customizable pieces to build a flexible solution for their own needs.