3 Advantages to Outsourcing RCM

Streamlined revenue cycle management (RCM) is key to an ambulatory surgery center’s long-term financial success.

The revenue cycle is multifaceted, involving every aspect of coding, billing, claims submissions, and collections. “Because healthcare providers need to expend significant resources to manage the revenue cycle internally, many are choosing to outsource RCM in order to increase efficiency and reduce expenses,” said Regent RCM Director of Revenue Cycle Management Erin Petrie. The RCM market in North America is expected to experience a growth rate of 12% by 2021, according to a MicroMarket Monitor report.

Outsourcing RCM is projected to expand as ASC leaders recognize its benefits:

  • Enhancing quality of care while reducing costs
  • Increasing transparency and accountability
  • Improving cash flow and stabilizing the overall revenue cycle

Ambulatory surgery centers that opt to outsource RCM gain several competitive advantages:

  1. Specialized Expertise

The revenue cycle management landscape is not static; it is changing at a rapid pace. For healthcare providers to keep up with the latest updates to Medicare, Medicaid, the Affordable Care Act, and other guidelines, they must employ RCM specialists on their administrative staff to get optimal results.

Outsourcing RCM is a far more effective and affordable option for many ASCs. A company that specializes in revenue cycle management offers ASCs expertise in developing, executing, and refining billing and collection strategies. “These RCM experts know how to handle the most complicated challenges and plan for any imminent changes,” said Petrie.

  1. Smart Staffing

For ASCs to manage the revenue cycle internally, they must employ an experienced billing and coding staff with built-in redundancies. This costly investment is a necessity for in-house RCM; cutting corners and hiring inexperienced employees can cost ASCs hundreds of thousands of dollars per year.

Outsourced RCM providers are ideally positioned to attract experienced staff with deep knowledge of the revenue cycle. They are RCM specialists, so they know how to recruit and hire the best employees in the industry, often maintaining a pipeline of qualified applicants waiting for a spot to open up. They also offer competitive salaries and benefits, and situate their offices in desirable locations.

  1. Best-in-Class Technology

ASCs often do not have the appropriate tools or resources to manage the revenue cycle in-house. ASC leaders are juggling tight budgets and favoring patient care over improved billing resources, and it’s simply not practical to invest in the most up-to-date RCM software and tools.

By outsourcing RCM, centers can take advantage of economies of scale and gain access to best-in-class technology. The team at Regent RCM uses three powerful technologies to track and automate the revenue cycle process:

  • A Management Information Systems (MIS) platform that helps maximize profitability, lower A/R days, and achieve faster reimbursement
  • Clearinghouse software that makes workflows more efficient, improving patient experiences and reducing outstanding balances
  • A reporting and analytics dashboard that creates real-time customized reports and offers deep insights into an ASC’s operations

Learn more about optimizing your ASCs revenue cycle through outsourcing by conducting a Self-Audit.

Regent Revenue Cycle Analysis

Regent RCM Presents Webinar Aimed at Helping Ambulatory Surgery Centers Gain Control & Efficiency

Regent RCM recently hosted a webinar aimed at helping Ambulatory Surgery Center (ASC) personnel gain RCM efficiency and control.

Led by industry veteran and Regent RCM Vice President Michael Orseno, the webinar provided insights in three key areas:

  • The evolving state of ASC RCM
  • Defining four components that drive competitive advantage for ASCs
  • Debunking common myths of outsourcing RCM

For those unable to attend, the webinar was recorded and is available now.

Please stay tuned for an upcoming blog series that explores these key areas in more detail. Contact Regent RCM to learn more or to speak with an RCM specialist directly at 312-882-7228.

ASC Billing & Collections

Regent RCM Client Makes a Case for Outsourcing Billing Services in an Interview with Becker’s ASC Review

Larry Parrish, administrator of Illinois Sports Medicine & Orthopedic Surgery Center (ISMOSC), explained why his center decided to outsource revenue cycle management (RCM) during a recent Q&A session with Becker’s Healthcare. He listed space and expertise as the main factors.
 
“If we had the physical space to accommodate the billing activity, we might have seriously considered it. However, accurate and effective billing is a very complex process, and you want to make sure you have very capable individuals providing those services.”
 
Parrish also lists eliminating the headaches of staffing, training, managing, and covering for sick leave/vacation as reasons he decided to outsource. 
 
Naturally, the big question was, “In retrospect, was this the right decision for your ASC?”  For the answer, read the full interview in Becker’s ASC Review. Spoiler Alert: The answer is “Yes.”
 
Are you an ASC administrator and ready to learn more about outsourcing RCM? Register for an upcoming webinar, “Gaining More Control and Efficiency by Outsourcing RCM.”
Black book endorsement

Outsourcing Meets Demands of New Reimbursement Models

A recent report from Black Book Market Research revealed that many revenue cycle management (RCM) platforms lack the necessary functionality needed to meet the demands of new reimbursement models. As hospital decision-makers evaluate new and evolving financial software, many are turning to outsourcing. As many as eighty percent of hospital CFOs consider outsourcing to be the best stop-gap measure.

Gaps and inefficiencies that lead to revenue loss are often due to complex processes in billing and collections. Resolving cash leakages is just one of the many benefits of outsourcing RCM. Other benefits include:

  1. Leveraging expertise in billing and collections, especially with coding changes brought on by ICD-10
  2. Workflow and process optimization that utilizes best-in-class technologies
  3. Smart staffing and avoiding the need for succession planning
  4. Real-time monitoring and reporting, giving actionable insight into AR days and collection rate trends

With the challenges of a rapidly changing health care model, outsourcing continues to gain momentum. Outsourcing RCM to an expert provider, such as Regent RCM, presents ASC’s with customized solutions and streamlines revenue cycle management processes.

Click here to sign up and read the detailed white paper on the Top 4 Benefits of Outsourcing RCM for ASCs.

revenue cycle review

Dispelling ASC Myths: Outsourcing revenue cycle management is more expensive

 

The Myth: Outsourcing our center’s revenue cycle management (RCM) will be more expensive than handling RCM internally.

The Truth: Outsourcing RCM can actually be more cost effective for ambulatory surgery centers (ASCs) after taking into consideration reductions in internal costs (salary, benefits, training, overhead) and potential increases in revenue from improved collections.

The Evidence: The myth that outsourcing RCM is less cost-effective often comes from the preconceived notion that ASC RCM charges are similar to physician RCM charges in the neighborhood of six to eight percent or higher. In reality, revenue cycle service fees average between three and five percent of monthly net revenue. Even at this more reasonable rate, some ASC’s may still argue that staff salaries for performing billing and collections internally would still be more cost effective. What gets obscured however are two important factors, the additional loaded costs of insourcing as well as the top line benefits of outsourcing.

As an example, let’s compare the cost of insourcing versus outsourcing for an ASC that produces 2 million dollars in revenue annually including two staff members handling billing and collections:

Insourcing costs would not only include this staff member’s salary, but would also include social security, Medicare, and unemployment contributions as well as employee healthcare costs. Overhead, IT costs, and training must also be factored in, along with succession planning costs including recruiting, interim coverage and potential revenue lag. Let’s not forget the intangibles that are even harder to measure, like the impact of employee time off, which could delay claim submissions for several days or burden other employees with shared responsibilities, directly impacting their primary job functions.

Solely based on reduction in costs, the center may be able to realize annual savings by outsourcing billing and collections. Once you factor in annual collection improvements from the RCM provider, which conservatively may average between two and five percent, the total annual financial improvement becomes even more compelling in the outsourcing scenario.

RCM-CostChart-0915 (1)

ASC physician looking at revenue cycle data

Dispelling ASC Myths: Will we lose control if we outsource revenue cycle management?

The Myth: Outsourcing revenue cycle management (RCM) can diminish an Ambulatory Surgery Center’s control.

The Truth: Outsourcing RCM can actually increase an ASC’s control by utilizing experienced, dedicated staff focused on creating processes built around transparency and communication.

The Evidence: When an ASC performs billing and collections internally, there oftentimes is not a dedicated full-time staff member whose sole focus is on revenue cycle. They may be assisting with reception duties, dealing with medical staff, troubleshooting IT issues, or even helping triage patients. However an outsourcing company provides a dedicated specialist that is focused on using technology, automated workflows, advanced analytics, and overall industry expertise to help the ASC gain more control and prevent costly mistakes.

Utilizing best-in-class technologies for workflow and process optimization along with reporting and analytics is critical to the success of an ASC, especially when it comes to billing and collections. Outsourcing RCM can give an ASC access to, and oftentimes discounts on industry-leading technologies like a management information system (MIS) designed exclusively for ASCs and real-time management consoles. An industry-specific MIS is necessary for integrating core workflows including surgical scheduling, insurance verification, inventory management, patient billing and collections. Uploading payer contracts into the MIS allows the facility to run a Contract Variance Report which shows all cases that were completed and what the center is expected to receive for payment. This provides realistic estimates of net revenue and increasing control of revenue cycle management. Real-time management consoles with custom metrics relevant to a particular ASC can also be built which provides increased transparency between the ASC and the RCM Company.