Outsourcing Your Revenue Cycle Management

August 12, 2021

Running a healthcare organization or hospital is hard work. Every day and every patient is unique. For many doctors and healthcare executives alike, the complications of medical billing, dealing with insurance payers, and having consistent cash flow are major areas of stress. That’s why more healthcare organizations than ever are outsourcing their revenue cycle management systems to third-party companies.

What Is RCM Outsourcing?

Healthcare providers and executives usually have one major thing on their minds: providing quality patient care and getting good results. Many would rather let their Accounts Receivable and insurance specialist staff worry about the billing process and bottom line. However, staff members in these departments are often overloaded with claim creation tasks, charge capture, billing follow-ups, complex coding, and denial management. It can be hard for them to keep up with the latest regulations and changes in RCM practices, resulting in inefficiencies in workflows. That’s where revenue cycle management outsourcing comes into play: they can give these tasks to a third-party organization that specializes in them, and both organizations reap the rewards.

There are definitely advantages and disadvantages to outsourcing revenue cycle management work. But for many healthcare executives, it’s worth the risk because these organizations have bountiful resources and knowledge to manage hospital finances—especially in the midst of recent turmoil in the industry. Revenue cycle management is also a growing market, and it’s important to perform these tasks swiftly and correctly if a healthcare organization is to stay financially healthy.

In fact, the revenue cycle outsourcing market is expected to grow at a compound annual growth rate (CAGR) of 11.9 through 2023, rising from $11.7 billion in 2017 to $23 billion by the end of 2023. Having an outsourced RCM system could be vital for many healthcare organizations if they want to take advantage of this boom.

The number of healthcare organizations that are outsourcing RCM has been steadily rising in recent years. According to Black Book Market Research, this number has grown by 48 percent since 2015, and 94 percent of hospital leaders are considering or vetting outsourcing companies. This is because for many of them, especially in this economic climate, the way their current revenue cycle management and reimbursement system is working…really isn’t. Bad debt piles up, especially for smaller organizations, and having to eat additional costs due claim denials and a lack of patient payment puts a red streak through their finances and damages their profitability.

Why Are Healthcare Organizations Outsourcing Revenue Cycle Management Work?

Healthcare facilities and organizations usually end up outsourcing RCM for three main reasons:

  1. Their current, in-house billing system isn’t ideal and they need to replace it with something different. Otherwise, they will continue to lose money and be unable to meet their bottom line or otherwise function as they should.
  2. They want to focus on providing quality care and improving the patient experience, not on whether they’re actually making money.
  3. Letting a trusted outside revenue cycle management company manage their finances will help them develop and implement strategies to cut down on costs and operate more efficiently, while not having to employ any extra staff members to do it.

To many leaders in the healthcare industry, outsourcing billing and revenue cycle management services just makes sense. Outsourcing allows them to know what’s going on and adapt to the rapidly changing medical world while also taking a more hands-off approach. It also allows them to streamline the inner workings of their medical practice without doing much, if any, additional work.

Benefits of Outsourcing With DECO

Of course, if you’re considering outsourcing your revenue cycle management process, you want a medical coding and billing company that you can trust to take care of your finances and RCM services. An outsourcing partner needs to know what it’s doing and how the healthcare system works, from interacting with patients to securely managing EHRs to closely following HIPAA regulations. It needs to have its own reliable systems set up, and be willing to collaborate and communicate with providers and leadership. Healthcare organizations should consider outsourcing companies that offer:

  • Lower overall cost structure (while achieving similar performance)
  • Access to consistent, advanced revenue cycle technology
  • Proven ability to handle heavy healthcare finance workflows and improve collection rates
  • Ability to scale operations and adapt to changes
  • Access to centralized talent pools rather than geographically widespread talent pools

At DECO, our team works hard on a daily basis to meet all of these criteria. Our professional team works jointly with healthcare staff to maintain transparency and accountability. We take it upon ourselves to help patients effectively navigate the billing and insurance processes, and our secure, proprietary software keeps us up to date on what steps need to be taken next. Additionally, our 94 percent capture rate is evidence of how effective we are at keeping track of patient information and follow-ups. We visit patients while they’re still in the hospital to help them figure out next steps and insurance eligibility, while also maintaining a compassionate, professional, helpful presence so they know someone is looking out for them.

If you’re interested in learning more about revenue cycle management and outsourcing, contact us today!

Contact Us!