The healthcare industry keeps evolving by the day. As newer challenges emerge, providers find themselves struggling to address these issues. One of the biggest problems is efficient revenue cycle management (RCM) processes. According to research, 80% of healthcare are looking to outsource RCM services in the future. This can be attributed to numerous factors, including rising costs, constant regulatory changes, and lack of qualified professionals. In this article we will cover the rising costs in healthcare and how RCM outsourcing is helping address this challenge.
Rising Costs in Healthcare
The COVID-19 pandemic put the healthcare world into a frenzy with an overnight surge in healthcare needs. This put a high strain on hospital resources, increased the demand for healthcare workers and even led to physician burnout. According to data from PINC AI, clinical labour costs have increased by an average of 8% per patient day compared to 2019. This rise in healthcare costs has affected many aspects of the healthcare system. From lack of skilled resources, unprecedented economic conditions, constant regulatory change and operational issues, the healthcare system is experiencing multitude of issues. In revenue cycle management, there is little room for error. Due to the lack of professional resources and the high costs of hiring in-house resources, providers are actively looking to outsource RCM services.
Benefits of Outsourcing RCM
Outsourcing RCM does not just cut down on hiring costs, it helps optimize the entire revenue cycle. When you leverage the skillset of professional resources, you experience a smooth, error-free and hassle-free revenue cycle. The benefits of outsourcing RCM include:
Increase in Revenue
When a practice decides to outsource their revenue cycle, they start to experience reduction in errors, lesser denials, faster reimbursements, and an overall streamlined billing and coding process. RCM experts help optimise the RCM workflow and boost cash flow with the help of cutting-edge technology, and best practises. They also reduce the number of days in A/R and increase revenue.
Improved Patient Care
In the era of value-based care, the sole focus of every provider is to provide high quality care. But with the myriad of challenges in RCM, it is impossible for providers to keep up with it. Outsourcing RCM helps providers focus on what they do best—provide high quality patient care. It improves patient experience and eventually increases practice revenue. When you outsource RCM to professionals, you will experience reduced denials and a more successful claim rate. This also allows you to invest in quality resources and thus improve patient care quality.
Transparency
When you outsource your RCM, you get access to detailed performance reports and analytics. You can monitor your RCM operations and performance using these metrics and assess where you are falling short. You don’t have to be concerned with the hassles associated with the revenue cycle, such as coding, scrubbing, claims administration, denials, appeals, prompt follow-up, and patient statements.
Improved Operations
RCM alse allows providers to maintain a steady cash flow and increase revenue. The main benefit of outsourcing RCM is that you do not have to worry about hiring an in-house team. This helps you save costs as well as earn extra due to your newly improved RCM cycle. With an improved RCM, your practice operations will also start to improve and become more streamlined.
Clean Claims
Claims claims are those that are error-free and have no chances of being denied. Having a higher clean claims rate means that your practice revenue is increasing. Outsourcing your medical billing to skilled professionals ensures clean claims are being submitted and do not get denied. Human error will be less likely to occur, there will be more clean claims, and your practise revenue will increase as a result.
No Need for Staff Training
Healthcare regulations are constantly changing. It might be challenging to stay up to date with these rules and regulations. If you use in-house billing and coding experts, this means you spend a lot of money on training your team constantly as new updates come up. Not training your team means getting denied claims. By outsourcing your billing and collections, you can prevent the need for staff retraining. The revenue of your practise will increase as a result of outsourcing to qualified specialists because there will be less errors and denials in your billing and coding.
Improved Denial Management
One of the biggest challenges in RCM is handling denials. Claims can get denied due to many reasons: incorrect or incomplete coding, wrong use of modifier or code, or incomplete documentation. Outsourcing revenue cycle management can help providers lower the amount of claim denials. They have professionals that can quickly and efficiently identify and address denials, which can boost the revenue that healthcare institutions get.
Reporting And Analytics
For healthcare organisations, outsourcing revenue cycle management can result in better reporting and analytics. Talented individuals gather information about revenue cycle management activities, analyse it, and then use it to improve revenue cycle management procedures. Finding patterns, keeping an eye on important performance indicators, and making decisions based on data are typically included in these analytics.
Reduced Staffing Costs
Since the COVID-19 epidemic, healthcare hiring costs have increased dramatically. Since healthcare organizations no longer have to hire and train their own people to manage the revenue cycle, outsourcing revenue cycle management can result in a reduction in staffing expenses. Their professionals are in charge of all areas of the revenue cycle, including medical billing, coding, and collections.
Conclusion
RCM can be a challenging task to manage among the day-to-day processes of the practice. Managing the RCM becomes easier when you outsource it to professionals who are experienced in this domain and take regular training to stay updated on the latest regulations. Outsourcing RCM means improved revenue operations, increase in revenue, cleaner claim submission, reduced denial rates and improved practice workflow.
