Four Reasons 2020 is the Best Year to Outsource RCM Functions

We can all admit that 2020 has been an unprecedented year thus far – bringing a whirlwind of chaos and changes to healthcare and virtually every other industry around the world.  The good news is, change can often bring about unforeseen opportunities and other transitions that weren’t necessarily planned. While many hospitals and health systems are struggling through severe financial losses due to COVID-19 and the ripple effect it’s having on the entire revenue cycle – it’s not all doom and gloom. In fact – even for hospitals that aren’t struggling – there’s never been a better time to consider outsourcing various revenue cycle management functions. From prior authorizations and insurance/benefits verification to coding and charge capture, or billing and collections, to payment and denial posting  – there are a lot of areas  throughout the revenue cycle that could be better managed by an outside partner, while also containing costs.  If you haven’t considered outsourcing, or the time just hasn’t been right before – here are four reasons why now might be the best time.

1. Outsourcing Supports Immediate Cost Containment – While outsourcing may not fully replace all in-house RCM teams – select areas can certainly help save significantly on labor costs. For systems considering furloughs or layoffs, an outsourcing partner can rapidly deploy a team of highly skilled experts to support critical RCM functions. Or, for systems that may be overwhelmed with COVID-19 patient care and associated operational support – RCM staff can be shifted to support these vital roles, whether it be Incident Management teams, point-of-entry screening, or telehealth functions.  Your outsourcing partner can effectively assume vacant RCM positions at a reduced cost, as hospital staff is reallocated to other areas of need.
2. Outsourcing Affords You the Ability to Scale as Volumes Fluctuate – Most systems have no idea how to plan or forecast for patient volumes at this point. While telehealth volumes have skyrocketed, procedural volumes have plummeted. While many had anticipated massive COVID-19 volumes, most are seeing numbers that fall drastically below their regular averages in many areas. Some states haven’t even hit their COVID-19 peak yet – and others are still worried about the upcoming fall/winter as they anticipate the challenge of managing both flu and COVID-19 together. Will elective procedures surge, or need to be postponed, or even cancelled again? Will EDs and urgent care clinics be maxed out? To take the guess work out – no one knows what to expect. Outsourcing provides the ability to immediately flex resources to scale up or down as volumes fluctuate. This can help reduce labor costs, overhead costs, and keep operations moving swiftly and running smoothly – regardless of what the patient census brings.
3. Streamlining the Revenue Cycle Supports Long-Term Success – Contrary to popular belief, outsourcing isn’t just about cutting costs. It’s really about improving efficiency, enhancing performance and accuracy, and supporting continuous process improvement. By outsourcing RCM functions, you’ll be getting an outside look at your revenue cycle from experts who have seen it all, understand best practices, and can provide critical feedback on how your organization fares when compared to others of similar size and specialty. The additional focus will identify root cause issues, areas of opportunity, and will recover lost revenue that you never knew existed. From identifying un-coded or under-coded claims and opportunities for clinical documentation improvement to collecting on denials and underpayments to heightened accuracy and reducing aged receivables – outsourcing can help increase revenue, optimize reimbursement, and augment cashflow.
4. Outsourcing Accounts Receivable Functions Allows Organizations to Focus on Patient Care – Healthcare organizations aren’t positioned to focus on billing, coding, payer relations, or clinical documentation improvement – their primary focus is and should always be on exemplary patient care and delivering the best possible patient experience. Outsourcing non-patient-facing functions can help organizations keep their eye on what really matters, while leaving key business functions to the experts. Not to mention – getting the AR functions right the first time, will actually help improve the patient experience through timely and accurate billing and collections of insurance portions.

Is now the time to consider outsourcing your RCM functions? GeBBS Healthcare Solutions is a leading provider of technology enabled revenue cycle management solutions to healthcare providers and payers. To learn more, visit gebbs.com or request for consultation today.