Is Outsourcing RCM Right for You?

Jul 11, 2021 | Collections, Revenue Cycle Management

Through the financial uncertainty of the past year, ensuring a seamless patient experience and pursuing every avenue for reimbursement have become the two main priorities for revenue cycle management (RCM) professionals. Administrative burdens like reviewing denials and evaluating accounts receivable shouldn’t distract from more critical responsibilities.

Are you feeling overwhelmed by your daily tasks? It might be time to bring on a third party that can reduce your stress. This case study shows how we relieved the pressure on one organization’s team and reduced their A/R by almost 13%.

If you’re not sure that outsourcing your RCM processes is right for you, we have a white paper that discusses all the benefits of launching a partnership. Here are just two of them:

Improved Collection Rates
Busy RCM teams don’t have the freedom to check and double-check claims status. According to a 2020 Black Book report, nearly 90% of hospitals say they have outsourced or plan to outsource their billing functions because optimal collection rates are so hard to obtain. While RCM staff bear a multitude of responsibilities, a third-party partner has one objective: collecting reimbursement. Their singular focus relieves pressure on internal staff and drives income growth.

As COVID-19 challenges inhibited patients’ ability to afford care, Monument Health in South Dakota found that the avenue toward improved collection rates involves patient-friendly billing practices. The facility focused on patient financial education practices and more direct engagement with consumers to help drive successful reimbursement. While this process has proven effective, it can also be time-consuming—which is why many organizations choose to outsource the hands-off processes to collections experts.

Dedicated External Resources
To see an improvement in cash flow, hospitals need committed professionals whose sole responsibility is claims management. With resources spread so thin, it is nearly impossible for facilities to maintain the amount of dedicated focus required for a measurable difference in RCM success. However, third parties work as an extension of the current RCM staff, providing the necessary bandwidth to give claims management the attention it demands.

An RCM partner does not exist as an independent body from the hospital itself. The right partner will serve as an extension of the original team, providing personalized insight and wisdom to fill process and efficiency gaps. Arizona-based District Medical Group has seen measurable success by outsourcing its revenue cycle management responsibilities—and executives know the importance of finding the right fit. DMG CFO Craig Jones says the organization’s partner is like their “revenue cycle coworker,” offering resources for communication and collaboration that ultimately improve reimbursement.

If you want to see improved communication and increased reimbursement at your organization, reach out to our team at ARx; we’d love to learn about your needs and set you on the path to success. Or, if you’re still not convinced that outsourcing is the right move for you, get a firsthand look at our work in this case study—or read our full white paper to help you decide.