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End-to-End Revenue Cycle Management

4 Common Reasons Healthcare Organizations Outsource Their Revenue Cycle Operations

There are certain signs that make it apparent it’s time for a diet and exercise regimen, like if your belt no longer buckles on the usual notch, or you’re winded after climbing a flight of stairs.

There are also signs in your healthcare organization that are just as apparent, and they may indicate reasons to outsource your revenue cycle operations. To name just a few, payers have become more complex to navigate, and RCM technology is expensive to purchase, implement and maintain. Hospitals and physician groups are operating on razor-thin margins due to the rise in high deductible health plans and consumer-focused care. As all of these examples and many more come into focus, it becomes increasingly clear that your business office operations need a new diet and exercise regimen to keep up. Outsourcing your business office is like hiring a personal chef and trainer to help you change your lifestyle, not just go on a diet.

Take a look below at four common reasons healthcare organizations are outsourcing their revenue cycle operations:

General Issues Related to Revenue

If you’ve ever used a calorie counting app or a Fitbit to aid in health initiatives and weight loss, you can think of an outsource partner as the activity tracker. An outsource partner will help you look at your processes throughout the various areas of the revenue cycle and identify where help is needed. Each organization is unique in revenue cycle strengths along with challenges. Maybe you need particular help with self pay, or there is difficulty on the front end with registration staff asking for the right demographic and insurance information. Or you may have a big backlog of denials that are not getting the proper attention and follow up necessary.

Lack of Internal Resources

Perhaps you don’t have the time, energy, or knowledge to exercise and eat right. Outsourcing with a partner helps keep you accountable, because your successes are also successes for your partner. Studies show a workout buddy increases your chances of success by giving you more drive and push to follow through on your goals.

Often in-house RCM staff are overworked and lack the training and resources to properly perform all of the job functions required of them. An outsourcing solution can provide specialized expertise in areas of your operation —for instance, front end staff customer service training to improve the overall patient financial experience. A little bit of organization and training with an outsource firm can make big improvements to your business office operations.

Gym woman exercising with her personal trainer.jpeg

Centralizing CBO Functions

Centralizing business office functions is like meal planning and making the commitment to working out X number of times per week and sticking with it. If your health system is large and decentralized, or operating on different systems, it’s often difficult to function efficiently. Centralizing your business office through one third party outsource partner is a way to streamline processes and recognize economies of scale.

Leadership Changes

There are certain aspects and realities of health and fitness that you have little control over —like your metabolism or injuries/medical issues. Don’t blow your whole diet just because you came face to face with unexpected cake in the breakroom.

In much the same way, as a revenue cycle leader, you have little control over the comings and goings of senior leaders such as CEOs and CFOs. Outsourcing your revenue cycle operations to a trusted partner minimizes some of the stress involved in running a hospital or physician group operation.

There is always going to be surprise cake and leadership changes- in every organization. Working alongside an outsource firm provides peace of mind that your whole revenue cycle won’t be thrown off the rails in the wake of the surprise upset of leadership changes.

The Bottom Line

A healthy lifestyle takes time, diligence, and patience to achieve, just the same as managing a healthy business office and revenue cycle operation. There are many complexities involved and it’s hard to keep all of the pieces moving without some help. Outsourcing is like a major diet and lifestyle overall, it’s not necessary for everyone, but if your organization needs to lose more than five pounds and cut out soda, outsourcing could be the long term solution.


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