Why Healthcare Providers Are Turning to Outsourced RCM and Medical Billing?

Nidhi Thakur

30 Nov 2023

Healthcare providers face several challenges when it comes to managing the revenue cycle. As staffing shortages and financial challenges continue to exist, most providers are considering outsourcing their revenue cycle management and medical billing software development tasks. In fact, as per research, 61% of providers plan to outsource these services to a reliable healthcare software development team. 

In this blog, we will explore the reasons why healthcare providers are turning to outsourced services and how it is transforming the industry. 

Revenue Cycle Management Challenges

RCM or revenue cycle management is a process of managing all the financial aspects of patient care, right from the initial appointment to the final payment for the services. From administrative tasks to patient registration, coding, billing, claim submission, insurance verification, and more, RCM involves hundreds of tasks.

Further, the complexity of the healthcare system makes RCM even more challenging for healthcare providers. Given the regulatory requirements and multiple payment models, the healthcare staff struggles to track financial transactions. Besides, the increasing cost of healthcare puts pressure on providers to cut down the expenses without compromising the quality of care.

To top it all, healthcare organizations are also struggling with rising hiring costs, making it difficult to retain experienced or qualified staff, like medical coders, healthcare software developers, medical billing specialists, etc.

How Outsourcing RCM & Medical Billing Software Development Benefits?

Here are some of the top benefits of outsourcing revenue cycle management and medical billing to experts -

• Streamlines Billing and Coding Processes

One important advantage of outsourcing revenue cycle management software development is the expertise and efficiency it brings to the overall processes. Outsourced healthcare software developers are trained professionals who specialize in navigating the complexities of RCM like claim submission, medical coding, etc. By outsourcing these tasks, healthcare providers can ensure quick and on-time submission of claims, reduced claim denials, etc.

• Access to Latest Technology and Resources

Outsourcing Revenue Cycle Management (RCM) also gives healthcare organizations access to sophisticated technology and resources that might be expensive to set up on their own. RCM service providers invest in cutting-edge software systems, integrate electronic health records (EHR), and utilize analytics tools aimed at improving revenue performance. These technologies automate RCM tasks like checking eligibility, ensuring claims are error-free, and managing denials. This not only boosts efficiency but also lessens the administrative workload for healthcare providers.

• Enhanced Data Security and Compliance

Ensuring the security of patient data and complying with privacy regulations is crucial in the healthcare sector. RCM service providers follow strict security measures and regulatory guidelines to safeguard sensitive patient information. They implement robust systems to protect data from breaches and unauthorized access, providing healthcare organizations with a sense of confidence and peace of mind.

• Cost Savings and Improved Revenue

Outsourcing Revenue Cycle Management (RCM) enables healthcare organizations to enjoy substantial cost savings and enhance revenue optimization. The considerable expenses related to the recruitment, training, and retention of an in-house billing team can be reduced through outsourcing. RCM service providers handle the recruitment and training of their teams, eliminating these financial burdens for healthcare organizations. 

Further, outsourcing minimizes the risk of coding and billing errors, resulting in higher acceptance rates for claims and quicker reimbursements. This directly influences the organization's financial performance, leading to increased revenue and profitability.

• Offers Scalability and Flexibility

Outsourcing provides healthcare organizations with the flexibility to adjust their operations according to their requirements. RCM service providers can easily ensure a smooth process for billing and transactions via automation, especially during unexpected increases in demand. This scalability removes the necessity for healthcare providers to recruit and train extra staff, thereby saving a lot of time and resources. Furthermore, outsourcing enables organizations to promptly adapt to alterations in regulations and industry standards, guaranteeing compliance and reducing the likelihood of incurring penalties.

• Saves Time to Focus on Core Competencies

Monitoring revenue cycles demands a significant amount of time and resources from healthcare organizations. Outsourcing Revenue Cycle Management (RCM) development enables healthcare providers to dedicate their attention to their core strengths, i.e., delivering quality patient care. The responsibility for administrative tasks, including billing, collections, and follow-ups, is shifted to the automated RCM software. This empowers healthcare providers to invest more time and resources in delivering top-notch patient care; thereby improving patient satisfaction and fostering loyalty.

Conclusion

Outsourcing medical billing and RCM software development can help medical practices tackle challenges like rising costs, and staffing shortages while streamlining the overall healthcare processes and improving efficiency. However, it is crucial to find a reliable third-party software partner with experience in developing custom healthcare software solutions for businesses like yours. 

At Ditstek Innovations, we specialize in providing custom healthcare software development services for businesses of all levels. With 10+ years of experience, we have helped hundreds of global clients optimize their healthcare processes with our custom RCM, RPM, EHRs, and medical billing software solutions.

Have a healthcare software idea in mind? Feel free to get in touch with us, and we’ll turn it into a winning product. Share your vision at info@ditstek.com