RCM Steps

Choosing Reliable Revenue Cycle Management Outsourcing Partner

What is Healthcare ​RCM Outsourcing?

Revenue management cycle is important to simplify administration for medical institutions especially for hospitals. Outsourced healthcare companies, offers all-inclusive healthcare and medical ​services; starting from a pre-registration to scheduling of appointments which even includes medical billing and coding.

These outsourcing companies successfully achieve HIPAA compliance and get ISO 27001 and 9001 certified to enable a systematic approach which make sure the protection of patient details and increases the effectiveness of clients' overall operations.

An incompetent system ​can have many unpleasant effects and negatively crash multiple types of aspects of a medical organization.

Those companies who have expertise in this domain of revenue management deliver quality ​ and undertake swift reimbursement as well as have better administrative procedures as a definite outcome.

Outsourcing Partners for Revenue Cycle Management (RCM) Solutions

Outsourcing ​will make sure a more modernized, affordable medical billing procedure, which will result in a decrease in the present write-offs, with a speed up revenue generation cycle and help in building an enhanced patient provider relationship.

  • The ​RCM services for the medical industry comprise of medical insurance claims processing solutions, medical billing, medical coding which mainly focus on the required data quality and information accuracy in the healthcare industry.

There are companies which provide advanced and affordable solutions to all the large scaled, medium scaled as well as small scaled global customers.

These ​healthcare service providers assist in collecting payments on submitted claims; boost the revenue from low paid claims, and consistently follow-up with insurance companies for faster settlements. In addition, they support with the medical billing and coding.

Along with that they offer entire patient registration with the eligibility verification which streamlines the processes right from the start.

Customized Revenue Management Cycle Outsourcing Solutions

Whether you are a medical service provider or an independent physician, a good ​service provider can enable you with its medical services and required support that will meet your precise healthcare needs.

Here is the list of processes included :

Patient Registration

The ​service providers assist you in processing your patients' demographic data and information. They take care of all the data entry of the patients' individual and the required insurance details. They also verify and validate the needed medical case related information. Once this procedure has been finished, the registrations of these patients are done.

Claims Generation and Submission

Claims Generation and Submission

These ​companies can handle both electronic claims submissions and the required submission of paper claims. Their completely experienced team organize Explanation of Benefits (EOBs) and submit the needed claims to the authorized medical insurance company.

​Medical Coding

Medical Coding

These outsourced companies work in agreement with timely restructured healthcare standards as well as methodologies generated by CMS, AMA, Medicare contractors, federal organizations and medical societies.

​Charge Capture

Charge Capture

These outsourcing service provider companies have different teams to manage and process charges for numerous specialties. Only a good company having far-reaching experience in handling these stuffs should be hired for better results which include:

  • Medicare and Medicaid services
  • 3rd party liability
  • Better managed care
  • Ideal provider organizations
  • Guaranteed insurers
  • Compensation of workers

​Payment Posting

Payment Posting

These outsourcing service providers make sure swift and precise posting of all the required payments into the billing system. Regular auditing of all posted payments is executed by these providers which assist in reducing the errors being generated in the different types of medical processes and while capturing of required information.

​Denial Handling Services

Denial Handling Services

These outsourcing companies can assist in the analysis, correction, and re-submissions of denied claims. This procedure includes identifying denials by the utilization of revenue coding and the required CPT/HCPCS codes.

Once this is completed, the different reasons for the denials are analyzed and a comprehensive denial management report is being made ready. This process helps in effectively managing all the required claim denials.

​Accounts Receivables Services

Accounts Receivables Services

These companies can assist you in identifying the required patient accounts that need follow-ups and take the necessary action to collect unpaid or underpaid claims.

​​Solutions for the medical industry additionally include:

The revenue cycle management solutions for the medical industry additionally include:
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    Detection of the grounds for claims denials
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    ​Utilization of CPT and ICD-9 codes
    Utilization of CPT and ICD-9 codes
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    ​Checking of Claims Authentication
    Checking of Claims Authentication
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    ​A/R Collections
    A/R Collections
    Checking of Claims Authentication
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    ​Charge entry as well as payment posting
    Charge entry as well as payment posting
    Checking of Claims Authentication
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    ​Capturing and coding of charges
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Follow-Up of insurance
    Follow-Up of insurance
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Management of denial
    Management of denial
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Follow-up of patients
    Follow-up of patients
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Follow-up of pending claims
    Follow-up of pending claims
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Analysis of payments and receivables
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Regular and accurate reporting
    Regular and accurate reporting
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​All types of modifications and adjustments
    All types of modifications and adjustments
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Payment promptness for diverse payers
    Payment promptness for diverse payers
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Payer mix and the maintenance of credit balances
    Payer mix and the maintenance of credit balances
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication
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    ​Provider enrollments as well as credentialing
    Provider enrolments as well as credentialing
    Analysis of payments and receivables
    Capturing and coding of charges
    Checking of Claims Authentication

Monthly Reports for improved processes

Your revenue management outsourcing partner can also support you with preparation of monthly reports that can assist in managing the required cash flow and boost profitability.

This takes in account all the reports in relation to hospital revenue cycle management services that can be of assistance to work with improved medical oriented processes.

​Streamline Cash Flow 

An outsourcing service provider with long enough experience, who has invested in resources and understanding of the industry proves to be the perfect business partner for the growth of healthcare practices. You can get assistance in multiple ways by outsourcing medical revenue cycle management services to an outsourcing expert.

The key benefits include:

​Commitment of Data Protection

Commitment of Data Protection

Outsourcing service providers who have achieved HIPAA compliance and who are ISO 27001 certified better safeguard your data. In fulfilment with these standards for data security, they have stringent protocols in place to uphold Protected Health Information (PHI) and other required business related data.

​Precision of Output

Precision of Output

In agreement with ISO 9001 quality management standards, these service providers strictly follow the finest and best practices for every step of the revenue cycle management procedure. They have experts who are qualified professionals and provided with process oriented training to smooth the progress of set up medical industry related work. This makes sure that the outputs produced for your business are precise and conveyed within the precise deadline.

​Rapid Turnaround Time

Rapid Turnaround Time

This outsourcing service provider companies work with 24x7 operations offering your business with a time zone benefit. Outcomes are delivered to you as per your industry requirement, which will make sure that you achieve the best process efficiencies that are better than what would have been provided through in-house resources.

​The Necessary Scalability

The Necessary Scalability

These types of companies have the best skilled talent and methodological resources to bring suppleness and customization to the medical projects that are outsourced to them. They are equipped to scale up their available resources as per your healthcare related business needs. This will reduce the load of non-core work on your in-house team of medical and administrative human resources, assisting them to just focus on attaining the mission critical responsibilities.

​Differentiating Benefits

Differentiating Benefits

You need to find a reliable outsourcing partner for all your healthcare requirements, which comprises medical record indexing, medical customer service, medical billing, health related data entry, receivables management and end to end processing of healthcare related claims.

Leveraging ​expertise can further assist you with

  • Improvement in the overall collection ratio
  • Raise the required probability of payments
  • Boost the needed and involved revenues

Benefits of Revenue Cycle Outsourcing  

  • Get full access of trained professionals without making any added investments
  • Save on overall medical operating costs at affordable outsources work charges
  • Leverage the HIPAA compliant procedures for improving revenue collection
  • Full access to 24x7 services that makes sure more rapid turnaround times
  • Carry out periodic follow-ups to boost payment collections
  • Explore refined technologies to your business process improvements

Key Takeaways

Steady, reliable and predictable outcomes generated through your revenue management outsourcing partner will empower your medical business from all the corners to work out on the larger picture and enhance the required profitability.

You must choose a committed outsourcing partner who can build a long lasting relationship with your company along with providing needed and effective medical support services.

Wide ranging experiences of working with global clients are a plus while choosing a right medical services outsourcing partner which can give full reliability and that can better assist you to work more successfully in the healthcare industry.