Every healthcare provider, regardless of size, must efficiently manage their revenue cycle for financial stability and operational efficiency.
Healthcare revenue cycle management involves complex tasks like obtaining accurate insurance information, coding, submitting claims, and coordinating with patients.
In the past, providers had in-house staff and specialized software for these tasks, but the increasing complexity took time away from patient care.
Nowadays, many providers opt to outsource their entire revenue cycle management to specialized companies. This eliminates the complexities, allowing external specialists to handle the process faster, better, and more cost-effectively. With this, providers can redirect their focus to what matters most – taking care of patients.
Revenue Cycle Management Outsourcing
Here are some of the reasons providers typically outsource their revenue cycle management:
- Cost Savings: Outsourcing the revenue cycle to an expert company helps providers save costs by eliminating the need to invest in dedicated staff and software for RCM.
- Faster revenue generation: Outsourcing the revenue cycle to an expert company helps providers generate revenue faster. This is because RCM companies have expertise in submitting accurate claims in the first go, and then a solid follow-up process, which ensures claims are settled faster and you can see the revenue quicker.
- Reduce Bad Debts: Entrusting the revenue cycle to an expert company reduces bad debts for providers. Some of the reasons for bad debts are inaccurate claims, claims lost in the processing cycle, invalid insurance information, etc. RCM companies are very good at handling all these aspects, as their specialists are specifically trained to handle all these scenarios. This results in a reduction in bad debts which are caused due to human errors or lack of enough follow-ups.
- Focus on Patient Care: Most importantly, outsourcing Revenue Cycle Management allows providers to redirect their focus from administrative tasks to patient care.
There are several ways through which healthcare organisations can improve revenue cycle management. Choosing the right Revenue Cycle Management (RCM) outsourcing partner is a complex decision, requiring careful consideration of multiple factors. In this paper, we will highlight six key considerations to help healthcare providers make an informed decision.
6 Key Considerations when Outsourcing RCM Services:
- Consider the company’s experience:
When deciding to hire an RCM service provider, the first aspect to consider is their experience in managing revenue cycles for various providers, including small and large entities from different fields. Research the company’s tenure in the industry, review their past and current clients, and assess the reputation they have built in the market.
You should look for a company like Talisman Solutions, which has almost 20 years of experience in this field. Having worked with providers from various fields, including Primary Care Physicians, Cardiologists, Dermatologists, Neurologists, Psychologists, Psychiatrists, Dentists, and more, the company is well-geared to handle Revenue Cycle Management service for any provider, irrespective of its speciality or size.
- Knowledge of Insurance Companies:
The crucial element for effective RCM in healthcare is a deep understanding of insurance companies/payers. When deciding on a service provider, assess their knowledge of claim submission, issue resolution, follow-ups, and interactions with major payers. The more knowledge they have of different state and national level payers, the better.
The team at Talisman Solutions has built a profound payer knowledge for smooth operations, faster issue resolutions, and expedited claims. The team of experts stay updated on diverse requirements, procedural changes, and policies of all major payers to ensure accurate and timely processes.
- Team expertise:
The effectiveness of an RCM service provider ultimately depends on the expertise and efficiency of its RCM team. When choosing a provider, assess the skills of teams managing coding, follow-ups with patients and payers, and other tasks related to RCM. Opt for a company with a skilled and expert team, indicating their proficiency in handling diverse requests and performing tasks accurately.
The team at Talisman Solutions is highly qualified, and experienced, and is equipped with the latest tools to efficiently handle the end-to-end RCM process while focusing on increasing revenue realization and reducing turnaround time.
- Compliance Adherence:
Patient data privacy is of paramount importance, making it crucial to ensure that your potential outsourcing partner strictly adheres to healthcare rules and regulations. Verify their comprehensive understanding and diligent implementation of HIPAA guidelines in their day-to-day operations. If you find that the company you are considering for outsourcing follows all laws, and rules, and stays compliant, this is a positive sign, and choosing such a company as your outsourcing partner is a prudent decision.
Talisman Solutions recognises the importance of patient data and related information privacy. That’s why we adhere to HIPAA guidelines when managing the revenue cycle for our clients.
- Technology Integration:
In the contemporary landscape, the use of digital tools, including software and AI-powered applications, has become synonymous with accuracy and efficiency. It is imperative to assess the technological capabilities of the RCM service provider you are considering for hire. If they utilize advanced tools and systems that seamlessly integrate with your current infrastructure, it is a strong indicator of their commitment to efficiency, and you should strongly consider such an outsourcing company.
Talisman Solutions embraces advanced technology to streamline work, ensuring both speed and accuracy. With the use of state-of-the-art software and AI tools, seamlessly integrated with the client’s technology, promoting a smooth, error-free workflow.
- Communication and Transparency:
Effective communication is paramount when entrusting a crucial aspect of your operations to an outsourcing company. The efficiency of problem resolution hinges on the quality of communication channels established between your team and the outsourcing company.
Additionally, transparency in reporting is key. A company that conceals information during reporting cannot be trusted.
At Talisman Solutions, we provide clear and open communication channels, along with a commitment to transparency in our reporting practices.
Conclusion
Outsourcing revenue cycle management services holds immense potential for providers seeking financial optimization and operational excellence. By considering factors such as the company’s experience, knowledge of payers, team expertise, compliance adherence, technology integration, and communication, providers can make an informed decision in selecting the right outsourcing partner. In this landscape, Talisman Solutions stands as a beacon of reliability, encompassing all six things mentioned above. Entrust your RCM journey to Talisman Solutions for a seamless and effective experience, establishing us as your trusted outsourcing partner.
