Claimocity Claims
Benefits of Outsourcing
Revenue Cycle Management
Why Top Practices Outsource RCM
Are billing tasks stealing hours from your day? A healthy practice needs strong finances—but administrative work shouldn’t control your schedule.
Managing the revenue cycle efficiently is crucial for the financial health of any healthcare practice. But, for many inpatient providers, handling these tasks in-house can lead to unnecessary strain on resources and team members. Outsourcing Revenue Cycle Management (RCM) is the practical solution, helping practices simplify operations, improve cash flow, and free up valuable time. Let’s explore how outsourcing your RCM can help you streamline operations and improve your bottom line.
What is Revenue Cycle Management (RCM)?
Revenue cycle management is the backbone of healthcare billing—tracking patient care from check-in to final payment. It’s a complex process involving claims, payments, and everything in between. This process can be handled by in-house admin teams, third-party vendors, or some combination of the two.
When done right, RCM reduces errors and speeds up payments, allowing doctors to reclaim their time. Yet, each step of revenue cycle management needs to be optimized and monitored. If a systemic error prevents clean claim submissions, denials can pile up quickly. Yet, even the best claim scrubbing process won’t get every claim approved the first time.
Financial Benefits of Outsourcing Revenue Cycle Management
Archived reporting from Healthcare Financial Management Association (HFMA) that’s still widely cited suggests that outsourcing RCM can boost collections by up to 15%. Still, you have to factor in the cost to collect. An outsourcing vendor that can generate an extra $1 million for a hospital or medical group may still not be worth it if it costs them nearly $1 million to do it.
The latest strategy for large, complex hospitals and healthcare networks has been to segment accounts receivable into the most likely and most valuable to collect. This has been done largely with AI medical billing software. This HFMA resource states that “prioritizing patient and payer accounts by propensity to pay can lead to a 10 to 15 percent increase in collections,” even without adding new internal resources to the billing team.
HFMA Board Member Mary Beth Remorenko discussed the financial benefit that Partners Healthcare saw from outsourcing their revenue cycle management in terms of the full-time equivalent (FTE) of in-house billing specialists. “We have seen a financial lift of about $30,000 to $50,000 per FTE, making this type of [outsourcing] agreement worthwhile.”
More Reasons to Outsource RCM
Outsourcing RCM can transform the way your healthcare practice operates. Here are the key reasons providers are making the switch:
Leverage Expert Knowledge and Tools
Outsourcing RCM with partners can bring years of expertise and innovative technology to your practice. It’s not just segmenting your AR workflow. Advanced tools like AI-powered charge capture boost efficiency throughout the revenue cycle by addressing common pain points like coding errors and incomplete patient information. At Claimocity, our inpatient and hospital billing software helps providers submit claims more accurately and efficiently, removing guesswork and minimizing errors.
Save Money
Maintaining an in-house RCM team comes with significant expenses, including salaries, training, and software. Outsourcing eliminates these costs and offers a flexible solution that can grow with your practice. Industry sources show that outsourcing can reduce billing costs by 30% to 40%. When you outsource, you’ll lower your overhead, improve cash flow, and bypass the ongoing challenges of staffing and training.
As for the cost of outsourcing RCM services, it’s difficult to quote meaningful prices without knowing the scope of your organization. Flat-fee agreements could cost a few hundred dollars a month to several thousand. Pricing models for larger organizations are often negotiated between 4-10% of total collections.
Streamline Your Workflow
Billing tasks can eat up a significant amount of staff time. Outsourcing simplifies these processes by automating tasks like claims submission and payment posting. A reliable system will reduce delays and speed up reimbursements, making your workflow smoother and less stressful for your team. With Claimocity’s tools, providers can achieve a 99.6% clean claim rate, meaning fewer delays and faster payments.
Minimize Errors and Denials
Billing and coding errors don’t just hurt your revenue—they create unnecessary stress for your entire practice. While 86% of claim denials are avoidable, according to Becker’s Hospital Review, most practices lack the tools to prevent them. Outsourcing these tasks reduces these mistakes by leveraging skilled professionals and automated systems like Claimocity’s AI medical billing software, which identifies and addresses potential issues before claims are submitted—ensuring smoother operations and maximum reimbursement.
Simplify Compliance
Staying compliant with healthcare regulations can be overwhelming, especially with the constantly evolving coding regulations. These changes make it challenging for in-house staff to stay updated, leading to potential errors and compliance risks. Outsourcing RCM allows practices to tap into specialized expertise that stays ahead of industry updates, reducing the risk of penalties and ensuring operations run smoothly.
Speed Up Payments
Getting paid on time keeps your practice running smoothly. The right RCM process focuses on speeding up payments by identifying bottlenecks. Outsourcing will allow you to delegate time-consuming tasks like claims processing, following up on overdue balances, and resolving billing issues. Your outsourcing experts can take care of the details so you can enjoy consistent, predictable payments without the headaches. For a closer look at how effective RCM management can improve your bottom line, check out this case study.
Who Benefits Most from Outsourcing?
Almost any type of medical practice or facility can benefit from outsourcing some portion of your revenue cycle management. Often, the key to success is matching your organizational strengths with the type of support you seek.
Claimocity specializes in the complexities of billing for inpatient care. We work with enterprise-level organizations, community hospitals, and independent physicians who outsource their RCM.
We accomplish this by offering an all-in-one charge capture and RCM platform as well as more active support for providers who need end-to-end revenue cycle management. Still, we’re not right for every medical practice. Outpatient health providers use a different revenue cycle model that is more easily managed in-house.
How to Choose an RCM Partner
Choosing the right RCM partner can make all the difference for your practice. A good partner simplifies complex processes, improves your cash flow, and reduces stress for your team. Here’s what to look for:
- Proven Track Record: Experience matters when it comes to optimizing your revenue cycle and navigating evolving regulations, so choose a provider with a proven ability to adapt and deliver results.
- Innovative Technology: Look for advanced tools, like AI-powered charge capture, that boost efficiency and reduce errors.
- Denial Management: Choose a partner who takes a proactive approach to identifying and resolving denials quickly so your practice doesn’t miss out on valuable income.
- Focus on Compliance: Make sure your RCM partner is committed to keeping up with the ever-changing regulations and has tools to make sure you stay compliant.
- Personalized Support: Great partners offer training, onboarding, and ongoing assistance to keep everything running smoothly.
Increase Your ROI With Better RCM
Claimocity takes the stress out of RCM with solutions built specifically for inpatient providers. With 20 years of experience and intelligent solutions designed to maximize your revenue and optimize your operations, you can reclaim your time, your way.
- Save Time: Say goodbye to overwhelming paperwork and inefficient processes. With Claimocity’s easy-to-use platform, you’ll reclaim hours every week so you can focus on what matters to you.
- Boost Revenue: Don’t leave money on the table. Claimocity’s advanced tools improve billing accuracy, speed up payments, and ensure you’re capturing every dollar your practice earns.
- Simplify Compliance: Navigating regulations doesn’t have to be overwhelming. Claimocity’s built-in safeguards and expert support make staying compliant easier than ever.
With Claimocity RCM, you’re not just outsourcing your revenue cycle management—you’re upgrading your entire approach to practice management. Why struggle with complex billing challenges when there’s a better way with Claimocity?
Stop letting billing challenges hold you back. Get started today.
