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How the Right RCM Outsourcing Partner Can Help

Maintaining a healthy bottom line is one of the toughest challenges today’s physician practices face. Here are four common RCM challenges physician practices face—and how the right RCM outsourcing partner can help.

Maintaining a healthy bottom line is one of the toughest challenges today’s physician practices face. Eighty-three percent of practices with fewer than five physicians say slow payment from patients with high deductibles is their top collection challenge, a Black Book survey shows, while 82 percent say traditional, highly manual collection practices are strangling revenue.It’s one reason why an increasing number of physician practices are considering revenue cycle management (RCM) outsourcing—in full or in part—to meet their practice’s financial goals. But how can you be sure you’re selecting the right RCM partner?One approach: Look for a partner that will integrate and collaborate with your team in redesigning revenue cycle workflows and leveraging existing technologies for improved performance.Here are four common RCM challenges physician practices face—and how the right RCM outsourcing partner can help.

Challenge No. 1:

Practices want to optimize their revenue, but they don’t want to start from scratch with new and unfamiliar systems.

Solution:

Utilizing an integrative RCM approach—tying together existing technologies with advanced revenue cycle software with seamless integration—enables physician practices to implement new workflows and solutions for improvement without dramatic or costly changes.Most healthcare organizations rely on multiple RCM technologies—their electronic health record (EHR), practice management (PM) tool and other vendor solutions—to manage their overall revenue cycle. This often results in higher-than-average denials rates, according to a HIMSS survey. However, tackling this challenge doesn’t have to involve the purchase of a single RCM platform. Instead, a strategic RCM partner can help practices use software to integrate their revenue cycle processes and workflows from end to end.

Challenge No. 2:

Keeping up with regulatory changes and new requirements can be extremely time consuming, and many practices do not have an in-house expert to manage this task.

Solution:

Draw from the expertise of an RCM partner that stays up to date on all regulatory changes and offers practical strategies for compliance and performance. Otherwise, it can often take months or even years to fully understand and comply with new federal programs and regulatory requirements, such as meaningful use requirements and changes to MACRA (the Medicare Access and CHIP Reauthorization Act) from year to year. The best RCM partners have internal experts who educate practices on upcoming changes and help position them for long-term success.

Challenge No. 3:

Practices don’t have a clear view into their RCM performance.

Solution:

A true RCM partner will heighten transparency around a practice’s RCM performance. For example, offering access to an online portal enables practices to drill down into their results at any time, view highly visual reports that give practice leaders and physicians a comprehensive view of performance at a glance, and equip points of contact who regularly review performance with key insights to inform action plans for improvement. A high degree of transparency boosts performance not only by highlighting areas of strength and weakness, but also by breaking down data silos from the front-end to the back-end of the practice. Team members will also feel empowered to make a difference, knowing how their actions directly impact revenue and the practice’s overall success.

Challenge No. 4:

With a number of healthcare revenue cycle solutions on the market, it’s hard to identify the best option.

Solution:

Select a partner that has demonstrated experience in healthcare—preferably with practices of your size and type. By 2021, experts expect the market for healthcare revenue cycle software solutions to grow at a modest compound growth rate of 4.5 percent. However, not all of the RCM software solutions available were created by vendors with specialized expertise in the healthcare arena—and that makes finding the right vendor difficult. Ask questions related to the breadth of the RCM vendor’s healthcare experience and be sure to talk with or read testimonials from current and former clients about their experience to better understand what your practice can expect.

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Across the nation, physician practices rely on Pulse Revenue Cycle Management for a healthier bottom line. Learn more about PulseRCM.