5 Reasons Outsourcing Your RCM is a Good Idea
Improved workflows, decreased denials, dedicated RCM experts, better patients outcomes and more
The revenue cycle is complex and often full of inefficiencies, especially with the introduction of telehealth, yet its management is integral to the business of healthcare. Finding that perfect balance between the quality of patient care and the cost to provide that patient with care can be a challenge. One way healthcare leaders are combating this is by outsourcing their RCM.
By investing in a third-party RCM solution, hospitals and healthcare organizations can spend more time treating patients and saving lives instead of dealing with claims. Here are five ways outsourcing your revenue cycle management can benefit and scale your clinical operations while improving patient outcomes.
Improved reimbursement workflows
Outsourcing RCM allows healthcare organizations to leverage the expertise and specialized knowledge of experts dedicated to RCM. This often means gaining access to proven and vetted frameworks that streamline workflows and remove bottlenecks, decreasing denials
Due to limited resources, in-house revenue cycle management can become inefficient and wrought with errors leading to high abandonment rates. Hiring a third-party vendor can lead to faster claims submission, improved denial management and timely payments. This helps optimize revenue generation for health services, improving the organization's financial performance and stability.
Decreased denials, increased revenue
Third-party RCMs can analyze medical coding, documentation and billing data to identify potential issues or errors in claims before submission. Using industry leading technology, they can flag missing information, coding discrepancies and potential denials, allowing time to address these issues proactively, reducing abandonment. Essentially, outsourced RCM teams have more time and resources to work claim errors, denials and manage appeals. Appeal management includes:
Evaluating why it was denied
Sourcing the required information
Resubmitting claims within required periods of time
Dedicated, revenue cycle management experts
Dedicated RCM teams are crucial for a hospital or healthcare organization, but require a lot of resources and training to build a robust revenue cycle management team. Outsourcing RCM experts can help your health facility stay up to date with industry regulations, coding changes, payer requirements and best practices. This helps organizations optimize revenue generation, minimize claim denials and allows providers to focus on and prioritize care.
Additionally, having a dedicated team of RCM experts can bring your claim rate accuracy to nearly 100%. That means bringing in the kind of revenue that allows you to invest in up-to-date technology and practices, enhancing patient care.
Scalability and flexibility from end to end
A revenue cycle management company or third-party vendor can remove barriers to scalability created by inefficient claim submissions and payment workflows. As patient pools expand, expert third-party RCM teams can identify the bottlenecks and revenue leaks in RCM workflows, decreasing abandonment and preventing lost revenue.
As patient volumes fluctuate or new services are introduced, outsourced RCM partners can quickly adjust resources, technology and processes to accommodate these changes. Additionally, they can take a consultative approach and recommend best practices based on services rendered in accordance with regulations to minimize denials and maximize revenue.
Supports better patient outcomes
Streamlining your RCM with a third-party vendor opens up resources and expertise that can positively influence patient outcomes. By minimizing billing errors and maximizing claims reimbursement, healthcare organizations can allocate more resources to patient care. This then trickles down, making healthcare more accessible and affordable to patients while expanding the patient pool.
Additionally, the financial stability outsourcing RCM enables organizations to invest in state-of-the-art equipment, infrastructure and clinical resources, ultimately enhancing patient care and treatment outcomes.
Outsourcing RCM alleviates the administrative burden associated with billing, claims management and revenue cycle operations. Thanks to this, healthcare organizations can redirect their focus and resources to patient-centered activities, such as care coordination, personalized treatment plans and patient education.
Their knowledge and experience enable accurate documentation and coding, which not only optimizes revenue but also ensures the capture of critical clinical information. Accurate documentation supports better care coordination, care continuity and ultimately, improved patient outcomes.
Powering End-to-End RCM Solutions
If you are looking to maximize your claims and billing efforts, offload your RCM to proven experts like OpenLoop! We provide intuitive telehealth technology customized for your business and reimbursement needs. Our end-to-end RCM service is built to improve workflows, decrease denials and offer complete flexibility from first visit to final payment. We also specialize in telehealth specific billing and coding for your virtual care practice.
Interested in what we can do for your organization? Get in touch here!
Our full suite of white-labeled Telehealth Support Services include: