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Top Revenue Cycle Outsourcing Myths—Exposed

In this 5-part blog series, we explore the most common myths around working with a partner for revenue cycle management—and offer practical tips for gaining the most from your investment. Read our first blog, addressing why seamless integration of multiple solutions isn’t impossible, here, and our second blog here, combating the myth of an inevitable lack of communication in RCM partnerships.

Outsourcing Partners Provide RCM Support Beyond Billing

One of the biggest misconceptions around outsourcing revenue cycle management (RCM) is that third-party services only support billing. But a true revenue cycle partner digs deeper, seeking to fully understand your business from front to back—and offering proactive suggestions on ways to drive greater value and improve your bottom line.With two-thirds of healthcare providers seeking help optimizing existing RCM technologies, it’s important to identify what your practice hopes to accomplish from a partnership providing RCM support. The following are three key characteristics of a true RCM partnership that organizations should keep in mind.

A true RCM partner examines the entire claims lifecycle.

It’s important to ask key questions to determine what the main cause of financial frustration is. For example, what are the root causes of denials—and where are dollars typically lost? The ideal partner not only will work your denials, but also will educate your team on how to prevent them. This extends the value of the partnership by boosting your team’s skills and positioning your practice to optimize processes for long-term financial health.

The ideal partner understands the art and science of coding—and helps you leverage this knowledge.

Typically, physician practices struggle to capture the true value of the services they provide. This can occur when a physician performs two billable services during an office visit, but the insurer’s claims editing system bundles the codes. The result: Only one service gets paid. An experienced RCM partner not only can help you appeal bundled codes, but can also teach your practice how to avoid similar situations and more effectively capture revenue. This leads to a more streamlined partnership as practice staff become more familiar with best practices for coding and overall RCM support.

The best RCM support comes from partners that serve as an extension of your team.

Strategic partners don’t just look for ways to optimize revenue cycle efficiency. They also point out opportunities to strengthen your market position, such as by partnering with other specialists to offer new services that satisfy unmet needs in the communities you serve. By serving as another team member of a practice’s own RCM team, true partners take your organization’s abilities to the next level by finding inconsistencies and plugging-in needed, additional RCM support.The next post in this series will debunk the next biggest myth in RCM outsourcing:Partners don’t assist with reporting.

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As a healthcare revenue cycle management company, Pulse works to assess, analyze, and adjust your revenue cycle so your practice can run more efficiently. To learn more about how Pulse can support claims processing, advanced medical billing and more, visit our Revenue Cycle Management software page.