Revenue Cycle Management Processes - To-Outsource or Not-to-Outsource

Last Updated:
Apr 07,
Revenue Cycle Management Processes - To-Outsource or Not-to-Outsource

Deciding between in-house RCM services or outsourced revenue cycle management processes is not an easy task. It is imminent that healthcare administrators or physicians will be facing many obstacles and challenges in the course of decision-making. However, you do not have any tailor-made solutions to facilitate this process. Instead, they must watch out for warning signs that would help them determine whether their organization is ready to outsource RCM or not. Three vital indicators are given below:

Difficulty in managing insurance denials with missing information

On an average, each claim denied may not seem to cost much, but when there is a pile-up due to inefficient management processes, the costs will skyrocket. It is only prudent to outsource your revenue cycle management process for timely submission of denial claims.

Spending more time on paperwork and less time on patient care

Your organization might perceive that a well trained, dedicated staff will suffice to manage administrative and billing tasks. In reality, healthcare professionals, including physicians, spend more time filling out the necessary papers instead of giving quality care to the patients.

Handling the changes and repercussions of ICD-10

The purpose of ICD-10-CM and ICD-10-PCS is to collect more data on the improvement of the quality of patient care. In order to get to this level of quality, your organization needs to hire expert coders who are capable of handling 60,000 or more new codes.

When one or more of the above issues are present in your hospital or healthcare practice, it is only practical to outsource revenue cycle management processes to a healthcare service provider.

Why is outsourcing revenue cycle management processes highly recommended?

An effective revenue cycle management depends on a thorough and systematic process of data collection. It is mandatory to capture credible patient demographics and insurance. The entire revenue cycle management starts from the patient getting admitted in the hospital, undergoing treatment, claims post-discharge to settling accounts.

Two major drawbacks that can bring down the efficiency of hospitals:

  • Haphazard revenue cycle
  • Outstanding Revenues

When you see signs of poor workflow or backlog in revenue, it is time to redesign, rethink and analyze the processes of the RCM by updating the relevant technology for implementation.

Advantages of an outstanding revenue cycle management

  • Systematic and organized operations
  • Increased cash flow
  • Prompt revenue realization
  • Continuous tracking of key revenue cycles

The integration of process, analytics and technology is the key to an efficient revenue cycle management. Harmonizing business practices in the revenue cycle and integrating it with the clinical aspect of the patient care is essential.

Velan Healthcare Services is a global leader providing an array of revenue cycle management services in Healthcare business to prominent hospitals,  medical facilities, medical specialist groups, and healthcare providers.

We believe that our extensive customer base contributes to our experience and wealth of knowledge in the decision making and a speedy healthcare delivery. When there is a requirement for an end-to-end outsourcing revenue cycle management processes, visit our portal for a free consultation.

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