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3 Ways to Recognize When You Need Outsourcing Revenue Cycle Processes



Outsourcing Revenue Cycle Processes

Hospitals and physician practices of all sizes are being forced to re-examine their revenue cycle strategies and are in need of designing new rules of engagement with patients, staff, and payers. Some providers handle this pressure by outsourcing their revenue cycle activities to the medical billing companies.

In this blog post we discussed out three important indicators that show the need for outsourcing your revenue cycle functions for your practice or hospital:


1) Hospitals and physician practices of all sizes are under increasing pressure as more patients shift from traditional care to value-based care.

2) Providers have been dealing with declining reimbursements, higher risks, and tighter margins while trying to improve patient care quality.

3) Due to these pressures hospitals and physician practices have been forced to look for new ways to optimize their revenue cycle strategies.

One of the options these providers have is outsourcing their revenue cycle activities to a medical billing company. This blog post will outline three signs that will show you when your practice or healthcare institute needs to outsource its revenue cycle processes.

1) Under increasing pressure as more patients shift to value-based care:

The pressure on hospitals and physician practices to deliver high-quality care while also reducing costs has been steadily mounting in recent years. With the advent of value-based care models, this trend shows no sign of abating. Providers must find ways to reduce expenses without compromising patient care, and one area many healthcare organizations are looking to cut costs is in their revenue cycle operations. Outsourcing some or all of these activities to a medical billing company can be a smart way to reduce expenses without sacrificing quality.

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2) Dealing with declining reimbursements, higher risks, and tighter margins:

In addition to the challenges posed by value-based care, providers are also facing shrinking reimbursements, increasing risks, and tighter margins. This is making it more difficult for many organizations to turn a profit. The pressure to cut costs has led many healthcare providers to outsource some or all of their revenue cycle functions. This can help them reduce expenses without compromising patient care.

3) Forced to look for new ways to optimize revenue cycle strategies:

The combination of value-based care, declining reimbursements, and tighter margins has made it clear to many healthcare providers that they need to re-examine their revenue cycle strategies. For some of these organizations, outsourcing revenue cycle activities is one way they can optimize their existing workflows without investing in costly new software or hiring additional staff.

The recent survey by Black Book shows that 83% of hospitals outsource a portion of their accounts receivable and collections, 58% for contract management. Additionally, 68 percent of physician groups with 10 or more providers also use these services to optimize cash flow in addition to better service quality! With all this evidence at hand, it’s no wonder why so many health care organizations are considering partnering up with medical billing companies; there is definitely something here worth looking into…

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Inefficiencies in Revenue Cycle Processes

Doctors, it’s time to take control of your revenue cycle.

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Inefficiencies in revenue cycle processes include missing charges, the inability to identify billable and non-billable procedures, incorrect patient demographics and insurance information, faulty use of procedure codes and modifiers, unable to interpret EOBs and ERAs, unable to categorize denied claims according to rejection reasons. Because of a lack of billing, coding, accounts receivable, or denial experts; insufficient training; and lack of internal and external audits, all these inefficiencies occur. Because physicians are busy but unable to devote much time to revenue cycle operations, this might be one reason for the presence of such inefficiencies.

In-House Human Resources Problems

As a physician, you know it can be challenging to find the right staff on your team.

The revenue cycle functions require medical specialty expertise staff who are well trained and possess data analytics capabilities. Finding top experts is still a challenge for hospitals and medical clinics. According to a recent poll, almost 31% of hospitals and medical practices acknowledged that they lack enough candidates for open roles.Outsourcing can help your organization focus on what it does best by removing the cost and burden of staffing, training employees. Medical billing companies will hire representatives who are knowledgeable in providing excellent customer service for patients while also freeing up time that would have otherwise been spent recruiting new clients or processing old ones – all this without hurting revenue opportunities!

Collection activity is slowing down.

The trend of shifting more patients towards value-based care leads to higher deductible health plans and co paying. This means that collecting payments from them can be costlier or time consuming, than obtaining payer reimbursement

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As discussed earlier in this passage there seems like a tradeoff between getting paid immediately by insurance providers versus having lower rates on your own end as well.

The study found that the percentage of collections from patient accounts with balances greater than $5,000 are four times lower in comparison to low deductible health plans. Overall average self-pay after insurance payment made up 10% and 18%. The medical billing company will share patient eligibility and insurance benefits reports in the prior appointment, if required.


Medical billing companies are a great way to help doctors focus on what they do best. Outsourcing your medical billing can be the key to success for any hospital or clinic, especially if you want to reduce costs and free up valuable time spent dealing with paperwork. The benefits of outsourcing your revenue cycle functions include higher patient loyalty rates, reduced cost per transaction, increased cash flow due to increased collections activity & lower account balances. It’s important that physicians understand this information before deciding whether or not they should outsource their revenue cycles. If you’re interested in learning more about how our team at Medical Billing Services can work with you, contact us today!

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Shabbir Ahmad is a highly accomplished and renowned professional blogger, writer, and SEO expert who has made a name for himself in the digital marketing industry. He has been offering clients from all over the world exceptional services as the founder of Dive in SEO for more than five years.

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