Outsource RCM: Providers who spend too much on RCM staff and processes, or who experience a high rate of claims denials, should consider outsourcing their medical billing requirements. While our experts chase down payments, you can provide the care, receive the funds, and improve your key performance indicators.
Outsource RCM makes sense
Why Healthcare Providers Are Turning to RCM Outsourcing
Approximately 61% of providers plan to outsource RCM tasks in the future. Based on 2022 State of Healthcare Performance Improvement report, nearly one-third of hospital and health system leaders (63%) have pursued at least one outsourcing solution.
In the meantime, the global RCM outsourcing market is expected to grow by 17% annually from US$23.7 billion in 2022 to US$62.4 billion by 2028.
The benefits of outsource RCM are only increasing as the challenges associated with implementing RCM in-house increase. There has been an increase in the difficulty of both providing care and billing as a result of new, more stringent regulations. Financial pressures, including inflation and staff shortages, have intensified the need for better cash flow management. RCM is also complicate by mega mergers roiling the market landscape, including retailers acquiring primary care clinics and insurers acquiring providers.
Here is a summary of outsoure RCM advantages.
Outsourcing your RCM has eight specific advantages:
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Health care talent is scarce:
Recruiting efforts should be directed towards sustaining full staffs of clinicians rather than recruiting and retaining administrative staff. Health care experts should hire health care professionals, and dedicated RCM companies should hire their staff. In terms of finding and vetting qualified employees trained in payments and claims management, they know best how to do so.
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Your RCM should be cost-effective:
RCM is a science. RCM is their core competency, and thus dedicated RCM companies have refined their processes (and technology) to the point where they can perform the same work at a consistently lower cost per full-time employee than in-house RCM staff, even after accounting for profit. From patient registration through eligibility verification, financial screening, pre-authorization, and out-of-pocket estimates, external RCM companies improve processes and precision throughout the life cycle.
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Other cost savings:
Additionally, outsourcing reduces an organization’s direct costs for office supplies, technology, claims management, and compliance management. In most cases, the savings are greater than the costs associated with outsourcing.
- You net more revenue: Here is an example. A health provider that we worked with replaced its seven-member staff with an external RCM service company, resulting in a significant increase in revenue that far exceeds the capitation levels previously achieved. The majority of companies make less money when they opt out of capitation.
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Claims denials are no longer your problem:
In the health care industry, perhaps the most stressful part is the denial of claims, the resubmission process, and the intermittent success of appeals. As a health care provider, obtaining reimbursement can be a challenge, even if you have a decent success rate. By outsourcing to an expert, the burden of work is offloaded and the challenge is placed in the hands of a team that has mastered the art of submitting clean claims.
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Accuracy:
A dedicated RCM team not only masters the core processes, but is also less likely to make errors like incorrect coding – the focus of their work is to maintain clean claims. Furthermore, companies that provide outsourced RCM services increasingly use artificial intelligence in order to automate the process of converting clinical notes into billing codes that are most efficient.
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Scalability:
Is your practice growing? Your RCM staff will not be able to grow with the changes if they are not capable of adjusting. A third-party company can scale easily since it will have trained personnel ready to join the team if required, but only if necessary.
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Value-based care improves:
Lastly, outsource RCM is a good move for providers who are committed to delivering high-quality healthcare at a reasonable cost. If you outsource RCM services to the right partner, you are able to provide your care at a lower cost, thereby increasing the value of your care. There is a great deal of importance in that.
RCM billing is a highly complex business process requiring a high level of expertise. Clinical practitioners did not study medicine in order to become billing experts. You should leave it to the professionals, and you will observe a rise in quality and a decrease in costs. As soon as everyone is paid fairly, we will be able to tackle the other economic problems associated with health care.
Why Outsource RCM in 2024?
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- Focus on Core Competencies: By outsourcing RCM, healthcare providers can concentrate on delivering quality patient care without being bogged down by administrative tasks.
- Cost Reduction: Outsourcing can lead to significant cost savings by eliminating the need for in-house staff, infrastructure, and technology.
- Improved Efficiency: RCM experts bring specialized knowledge and advanced technology to streamline processes, reduce errors, and accelerate revenue collection.
- Enhanced Revenue: Outsourcing can help identify revenue leakage, optimize claim submissions, and improve overall revenue cycle performance.
- Compliance Adherence: RCM providers stay updated on the latest regulatory changes, ensuring compliance and mitigating risks.
Key Considerations for Outsourcing RCM
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- Provider Selection: Carefully evaluate potential RCM partners based on their expertise, track record, technology, and alignment with your organization’s goals.
- Data Security: Ensure that the RCM provider has robust data security measures in place to protect patient information.
- Performance Metrics: Define clear KPIs and performance metrics to measure the success of the outsourcing partnership.
- Contract Terms: Clearly outline the scope of services, responsibilities, and termination clauses in the contract.
- Transition Planning: Develop a comprehensive transition plan to minimize disruptions during the handover of RCM functions.
How does Allzone’s Medical Billing Company differ from other companies?
Medical billing services provided by Allzone’s company can greatly benefit healthcare providers. A professional billing company can provide numerous benefits, such as cost reductions, increased cash flow, increased precision, lowered compliance risks, higher patient satisfaction, and a greater focus on patient care.
Please contact us at 866-854-2714 or sales@allzonems.com. if you have questions about our services or would like to arrange a call. We look forward to discussing how we can help your healthcare facility succeed.
Contact us today to schedule a complimentary consultation!