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The Impact of Outsourcing Revenue Cycle Management on Hospital Operations

September 5, 2023

Outsourcing revenue cycle management (RCM) is common among hospitals that want to improve financial performance and efficiency. Hospital revenue cycle management involves the processes from billing to payment collection. Hospitals can reduce administrative costs, increase cash flow, and focus on the mission and vision by outsourcing these tasks to a third-party vendor. 

Benefits of Outsourcing Revenue Cycle Management for Hospitals

Many hospitals struggle with RCM due to workflow inefficiencies, errors, staff shortages, and changing regulations. Outsourcing hospital RCM services to an experienced industry leader can help overcome challenges and improve financial performance. Streamlining RCM helps hospitals strengthen the relationship and trust between the hospital and the patient by providing a better patient experience.

Increased Revenue and Efficiency

Outsourcing can help streamline and simplify billing and coding processes, reduce errors and denials, and ensure timely reimbursements. Experienced vendors leverage advanced technology, data analytics, and best practices to optimize the RCM workflow and increase cash flow. Fewer errors with billing and coding, decreased days in accounts receivable, and a significant decrease in denials are considerable benefits of outsourcing hospital RCM.

hospital medical professional going over document with patient
  • RCM in a hospital can enhance efficiency, allowing staff to focus on patient care and core activities. 
  • The outsourced company manages the hiring, training, and supervision of RCM staff and oversight on compliance and regulatory issues. 
  • Registration, insurance verification, eligibility checks, and patient collections are managed by outsourced RCM staff. 

Access to Expertise and Advanced Technology

Leading RCM companies have access to the latest technology and innovation – artificial intelligence, machine learning, automation, and cloud computing. Vendors must integrate seamlessly with a hospital’s existing systems and platforms – the electronic health record (EHR) system, practice management and billing software, and other ancillary support systems for the hospital’s RCM. 

The Direct Impact of Outsourcing on Hospital Operations

Effective hospital revenue cycle management solutions can improve financial performance and operational efficiency. The decision to consider RCM tasks is a step in the right direction. RCM in a hospital is a complex and time-consuming process requiring specialized skills and technology only an experienced vendor can offer. Outsourcing RCM to a third-party expert offers several key benefits.

Streamlined Administrative Functions

Outsourcing RCM can reduce the burden of billing, coding, and collecting payments, allowing hospital staff to focus on the mission and vision of the hospital. Accuracy and efficiency of the claims process improve, resulting in fewer denials and faster reimbursements. Other benefits include:

  • Quality improvement: Outsourcing enhances the quality of services or products by leveraging the expertise and experience of specialized providers.
  • Flexibility and scalability: Outsourcing allows hospitals to adapt to changing demands and needs and access new technologies and innovations.

Hospitals may enjoy a boost in productivity with outsourced hospital revenue cycle management. Experienced RCM providers develop accurate and timely reports, real-time dashboards, and insights on a hospital’s financial performance. These vendors offer guidance and direction on how to improve the RCM process and address any issues or gaps.

Reduction in Operational Costs

Using an outside service for hospital RCM can transform hospital operations, enhancing efficiency compliance and generating revenue. Reducing operational costs offers several advantages for a hospital’s bottom line, including: 

  • Cost savings: Hospitals can reduce labor costs, overheads, and capital expenditures such as technology, software, and hardware. 
  • The cost of training employees for revenue cycle management is also eliminated. 
coronis health hospital worker looking through medical documents

Outsourcing hospital RCM may be wise for hospitals that want to improve financial performance and operational efficiency. Partnering with a reliable, experienced vendor can save costs, ensure compliance, and promote revenue growth.

Potential Challenges in Outsourcing Revenue Cycle Management

Partnering with an experienced RCM company that prioritizes your best interests can help minimize outsourcing challenges such as:

  • Delays in communication: Communication gaps may hinder productivity, especially if different time zones or systems are a factor. These factors may affect the quality and timeliness of hospital RCM services, such as billing, coding, and collections.
  • Principal-agent conflicts: Hospitals and vendors may have different goals and incentives – a vendor may prioritize maximizing their profit over optimizing the provider’s revenue cycle performance. This can result in a conflict of interest and damage the relationship between the hospital and the vendor.

Data Privacy and Security Concerns

Hospitals must ensure that their RCM vendors comply with the Health Insurance Portability and Accountability Act (HIPAA) and other relevant regulations and that they have adequate safeguards to protect patient data’s confidentiality, integrity, and availability. Hospitals should also monitor and audit their RCM vendors regularly and have contingency plans in case of data breaches or other incidents.

Providing access to sensitive patient and financial data to vendors and subcontractors may pose security risks, privacy breaches, and compliance issues. Do your research to ensure that the company you choose to manage your revenue cycle has a trustworthy reputation and can confidently protect your patient data.

Outsource Hospital Revenue Cycle Management with Coronis Health

Coronis Health is a pioneer in hospital RCM. With decades of experience and a team of industry leaders, we can work with your hospital to reduce costs, improve cash flow, and enhance patient satisfaction. We can help manage your revenue cycle so you can focus on patient care, strategic initiatives, and the overall performance of your hospital. To learn more, contact Coronis Health for a 1:1 Executive Consultation to assess your current situation and identify areas of improvement. Don’t miss this opportunity to optimize your revenue cycle and achieve your financial goals. 

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