Introduction: Outsourcing RCM Services
For many healthcare institutions, even the thought of outsourcing their services to a revenue cycle management service company can be unnerving as it poses many challenges; one of them is coding and billing. Needless to say, medical coding and billing are among the important cogs of a healthcare firm’s machinery. If both are carried out in an accurate and timely manner, they can pave the way for a smooth revenue cycle, and if not then it can bump up costs. Therefore, healthcare firms fear transitioning to an outsourced RCM service from an in-house setup as, if not done correctly, it can affect the firm’s income and put it in a hole. However, the actual scenario is different.
To back it up with statistics, a National Health Insurer report says that around 25% of the claims paid are incorrect because of which healthcare firms have to suffer a loss in the range of 5%-14% of their total entitled revenue. Hence, to receive the entitled amount, the healthcare organization must outsource their RCM services to a well-credited revenue cycle management service company that is expert in matters related to denial resolution, bill modifications, claim appeal tender, and claim follow-ups. One must also look for credentials like whether the RCM services company has expertise in the ICD-10 & ICD 11 coding systems or not. This way a healthcare firm can transition to a reliable and holistic RCM services provider who can safeguard the firm’s liquid assets ensuring a positive cash flow, eventually boosting the healthcare organization’s revenue cycle.