RCM Software vs. RCM Outsourcing: Which Is Better?

Managing the medical billing, claims, and patient collections of a healthcare practice is a tedious process. Many companies choose to handle this process with an RCM software to keep things organized and up to date. Quick turnarounds, easy payment processing, and lower overhead costs are all benefits of RCM software, but it still comes down to your team’s capacity and expertise to handle your revenue cycle efficiently and effectively.

While many healthcare organizations succeed with in-house RCM software, sometimes it pays to have an expert team handle it for you by outsourcing revenue cycle management. If you’re considering investing in your practice and finding ways to free up resources, then outsourcing revenue cycle management can be an excellent option. Here’s what to know about the benefits of RCM outsourcing and how your financial performance can benefit.

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What is RCM?

Revenue cycle management (RCM) is the process by which medical practices collect payments from insurance providers and individuals for patient care services rendered. It includes everything from the recording of those patient care services to the collection of the final payment or reimbursement.

RCM is important for the financial health of practices and the experience people have with paying their bills. For example, the longer amounts sit in accounts receivable, the higher the risk that claims can go unfilled due to deadlines negotiated in a payor contract. Plus, people expect to see any bills for medical services arrive quickly so they can pay them and close the loop on their expenses.

What is RCM Software?

There are many types of RCM solutions such as software designed to help healthcare providers monitor and manage their revenue cycle across patients and services. Many of them create efficiencies by automating tasks such as billing and collections, and there are several software solutions designed for specific industries. Software is one type of RCM solution that can enhance cash flow, but there can be downsides including reduced patient satisfaction.

That’s because they still require your team’s input to some degree. The best RCM software automates much of the billing process and integrates with EMR to provide updates to linked accounts and follow up with billing reminders. This type of tool requires a significant investment, and can become a hindrance when tools are misconfigured or as a result of user error.

In addition, relying too heavily on software that may or may not be updated regularly opens the possibility of misfiling due to the ever-changing policies and protocols present throughout the revenue cycle process. Additionally, things like a labor shortage can increase the chances of medical coding errors when your team is strained for capacity. This is where having real people servicing your accounts is more helpful than making your team handle everything manually, or relying on impersonal servicing from an RCM software provider.

What is RCM Outsourcing?

RCM outsourcing is just that – when a service provider takes over the entire revenue cycle process with their own tools and labor. There are many reasons to outsource revenue cycle management but the most important come down to this: it frees your team to focus on your main mission – treating patients with quality care.

However, we understand that many private practices balk at the idea of leasing out sensitive or important information about their practice, which is why we go to great lengths to secure and anonymize data to provide peace of mind and HIPAA compliance at every step. Our team is focused on revenue cycle management, and we’re proactive with staying on top of regulatory and coding standard changes to prevent billing errors and streamline reimbursements.

We also provide the personal touch that the best RCM software dashboards may not provide when it comes to understanding your revenue cycle. We’ll handle all communication with regard to payors and patients when it comes to collecting bills and receiving reimbursement for claims. The value of these services often far exceeds the minimal monthly payment for outsourced RCM, since we’re experts at these tasks and have the technological infrastructure to manage them efficiently. Thus, in the long run, outsourcing revenue cycle management can help reduce costs when you don’t need to worry about whether you’ll receive your dues on time or not.

Revenue Cycle Management With PayrHealth

To learn more about how you might be able to benefit from the security and scalability of revenue cycle management that’s handled by our team of experts, call or contact PayrHealth online today. We are a leading RCM solutions provider in the healthcare industry and offer a variety of services for a variety of fields. With the right RCM partner, you can reduce costs and focus more on quality care. Our team of healthcare industry experts will be happy to answer any questions and provide a value proposition to see how we can help you boost revenue and receive payments from payors and patients more quickly.

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Payrhealth is a full-service payor-provider relationship manager. We see a future where providers and payors can make more informed decisions together to build a strengthened healthcare system. Learn more through a free consultation with our world-class experts today. 

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