One-Stop Solution For Revenue Cycle Management Services


How Much Does Healthcare RCM Services Cost in 2022?

Doctors and therapists with their own services should be able to focus on their specialty, rather than focusing on administrative tasks such as patient record management and billing services. However, these tasks are crucial and need to be maintained properly for there to be patient retention, engagement, and satisfaction. Without patients, you can’t run a practice and if you were to do the administrative tasks, you wouldn’t be able to see patients.

The simple solution seems to be to hire administrative staff and take on help from RCM services to help you run your practice efficiently. Only doing one of the two is not an option as your revenue is an important factor to be considered in the success of your practice and it shouldn’t fall short because of untrained staff. The options are to hire well-trained staff or train the staff appropriately to manage RCM services, or to outsource RCM services.

What is an RCM service?

An RCM service is a revenue cycle management service that uses medical billing software to smoothen out the billing and collection process, hence, increasing payments and revenues while reducing the need for collection agencies. The revenue cycle management services differ from practice to practice, based on the needs of the practice. Some of the common services included when outsourcing an RCM service are:

  • Charge capture and billing services
  • Insurance eligibility verification
  • Payment posting services
  • Denial management services
  • AR calling services

There are many more services, but the general idea and motive of each of them are the same; to ensure revenue and increase profits. The cost of these services differ based on the exact one you opt-out for, but they are generally dependent on several important factors.

You may not outsource RCM services, and have them managed by your well-trained staff, but the costs of these services are still to be considered.

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Factors that Influence The Cost of Healthcare RCM Services

The purpose of RCM services is to make the financial billing process smoother and require fewer hours. The costs of these services are bound to increase exponentially if your practice is riddled with the following problems:

Inaccurate or incomplete details regarding patients

RCM services use patient information in your system to follow up with them and having inaccurate information about the patient such as old address or not having all information of the patient such as insurance plans, can hinder the functioning of the RCM services, making it difficult for them to produce great results. That can cause the costs to go up and result in slowed revenue collection.

The increased financial burden of patients

Lack of transparency in your collection system can increase the financial burden on the patients, and create more work for RCM services to tackle. Creating a system where the patients are aware beforehand that the service doesn’t accept their insurance plan and then providing them with payment plans, can reduce the financial burden while also being more transparent. This not only increases payment collection but can also result in patient retention due to the transparency of the whole payment process.

Entering information manually

Automation of all administrative tasks is the easiest way to reduce the costs of RCM services along with the stress on your administrative staff. Record keeping and financial information of patients should be automated, and there should not be any manual recording of data in these aspects because the smallest error can delay your entire collection process significantly.

Incorrect and extensive medical coding

Medical coding is an important component of your healthcare practice but extensive use of them or using incorrect coding can hinder the efficiency of RCM services just like manual data collection. This is because there is a higher probability of claims denial with incorrect coding, and one thing you do not want to see during your collections and reimbursement process is claim denial. This backtracks the entire process, hence increasing AR days and delaying payments and revenues.

To improve RCM services and reduce the costs associated with them, it is necessary to perform introspection of how data is collected and managed at your service. This will give you an idea of where the most costs are adding up and you can easily manage them.

Is Outsourcing RCM the right choice for you?

After the introspection, if it is found that managing RCM services is too much of a task for your practice, it may be best to outsource to an RCM partner like Practolytics. You can choose the exact service you would like the outsourced RCM services to focus on, especially if you have found a specific problem area in your practice that is delaying payments and hindering your RCM services.

Apart from realizing that you need help, there are a few things you need to consider before you make the decision to outsource RCM services. You have to consider if you are actually going to save costs and time by outsourcing. The purpose of outsourcing is not only to make sure the process runs smoothly and there is an increase in revenue, but also to ensure that the cost of the service doesn’t take all the increased revenue. On top of that, you have to ensure your staff’s time is being saved and productively used elsewhere as a result of outsourcing.

Generally, you are most likely to be paying your staff for their services and are also paying for the training of the staff. Since it’s human to err, it’s likely that there are going to be errors in the data collection. However, outsourcing RCM services has well-trained staff with the sole purpose of streamlining the collection and payment process at your practice, meaning that there is a net decrease in internal losses. This, in itself, profits your practice greatly. And the costs saved by removing the need for training of the staff, adds to the profit. All of these increases in profit are there to make sure that you are not losing anything on the cost of outsourcing.


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