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Medical Billing Outsourcing Success – Scalability, Workflow Automation, Personalized Services.


The healthcare landscape is complex today. Private Practices have many other priorities. They must address issues such as declining reimbursements and Staff shortages. Partnering with medical billing service companies is a great way to create the optimal operating model to increase the practice revenue and improve efficiency and performance.

Outsourcing medical billing services is often linked to the notion of letting go. Letting go can be associated with uncertainty and anxiety about the results. You can save time and make the right choice to partner with you in order to find the investment needed for your strategic initiatives that will propel your company forward. Outsourcing can be a great option in these three areas, according to our experience.


Unending supply of certified and qualified revenue cycle professionals. The right partner should be able provide the resources you need, whether it’s medical coders or A/R professionals. Scalability is achieved through the right selection, training, and the proper fitment of diverse resources for both front-end and back-end processes. You will also need to have skills in finance, technology and analytics.


Your revenue cycle should be calculated as if you were in. People will be referring to automation and processes together in 2022. Your partner should have multiple technology capabilities, including the ability to measure and monitor agent productivity and apply machine learning and AI in order to reduce workload and improve results.


Sometimes, the missing link is often in outsourced relationships. Transparency means open communication, transparent reporting, and real-time communication. Transparency must be displayed in action, regardless of whether it’s flexing up or down staffing, reporting on their performance, or the ability for collaborative teams to include the hospital and service providers.

Partnering with revenue cycle outsourcing companies can offer multiple benefits including:

1. Implementation of effective processes throughout the revenue cycle chain

2. Report and measure individual process-specific SLAs

3. Provide specialized expertise, such as certified coders

4. You can use enabling technologies like workflow automation to give you an entire view of your outsourced processes

5. Automation can be used to reduce the total cost of ownership, beyond staff arbitrage

6. Your leaders should be able to concentrate on strategic priorities.

We are often asked by revenue cycle partners: How can we tell if it is time to outsource? How do we make sure that the outsourcing process is managed properly? What are the benefits of outsourcing our revenue cycle?


Here are a few things to look for in your partner:


Outsourcing partners for revenue cycle management can be a surprise to hospitals and healthcare systems due to the increased efficiency they bring to their revenue cycle. Outsourced service providers have the ability to bring together a wide range of services, including benchmarking performance against top-ranking hospitals and creating the underlying processes that achieve best-in class RCM KPIs. Outsourced service providers can provide a significant competitive advantage in times of staff shortages by deploying high-quality talent through their specialized recruitment, training and certification processes.

Flexible outsourcing arrangements – You may have to adjust your staffing requirements due to unpredictable demand. Access Healthcare partners can give you the advantages of scale and volume. You may require 100 AR callers in a short time. If you work with a partner who has deployed over 5,000 A/R calls, you can quickly achieve your goal and increase your A/R staff.

Innovation – All partners are not the same. Scalability is one thing. Future-proofing your company is another. Access Healthcare, for example, has invested in echo, a robotic process automation platform that uses AI and ML to bring innovation throughout the revenue cycle. Regular innovation is a sign that an organization understands the needs of its clients and can continue to provide solutions that add financial value to the hospital.


Many times, outsourcing decisions are made solely for cost-saving reasons. In the last two decades, medical billing outsourcing has reached an entirely new level of maturity. It is often not recognized that outsourcing can free hospital CFOs up to concentrate on strategic initiatives. It is extremely costly to not focus on strategic objectives.

Analytics – Analytics in revenue cycle outsourcing is designed to empower RCM decision-makers to make strategic changes. They can use the right analytics to make changes in how they measure quality and pay more attention to the patient experience. They can adapt the revenue cycle to new reimbursement models and changing guidelines in order to reach targeted financial outcomes.


In our conversations with clients, we emphasize that they aren’t “outsourcing”, but “onboarding” a partner. It is important to know what you can expect from your partner. Document everything, ensure you have performance data on-demand, and set up a framework for information exchange.

Leaders of hospital RCM must create ways for their staff to be able to concentrate on patient experience. They must also have the right insights from revenue cycles. Reports and insights are not the same thing. Partner should give insights and get your approval on the most important actions.

A good governance model will help you make transparent communications easier. Define the reports you would like to see. Create multi-level governance structures that include daily, weekly and monthly governance calls. Finally, create a business intelligence framework which gives you powerful insights into operations data.

The key to deciding on the size, complexity, and scale of the outsourcing partnership that you want to form is to have a clear understanding about the capabilities and technology ecosystem of your partner. This will allow you to focus on strategic initiatives.


Below are the main aspects to consider when creating a revenue cycle partnership.

1. Due diligence. Be sure to understand your partner’s capabilities before you sign a contract. You can validate their abilities and avoid making assumptions by doing your due diligence.


2. Contracting. Create a contract that clearly identifies the location of the partner, the SLAs to achieve, escalation procedures and processes, governance model, technology interventions and the timeframe for deployment.


3. Transparency. Transparency is essential when it comes to the outsourcing relationship. The partnership might shift your employees to the partner in many cases. Inform them that this is going to happen. Transparency also means technology for real-time reports and a solid governance model. Real-time information on agent performance, revenue cycle KPIs and inventories is available to you to keep your operations under control, while allowing your partner to manage the operational challenges. Your governance framework should facilitate transparent information exchange and decision-making.


4. Future-proofing. Your revenue cycle partners should have the technology to reduce collection costs, help propel your company forward, and make your revenue cycle ready for the future.


5. Take it slow. It takes time to build a relationship, as our experience shows. To achieve transformational results, outsourcing your revenue cycle can take as long as three or four A/R cycles. Although you can bank staff arbitrage gains quickly it will take several cycles to achieve scalable and long-lasting results. It will take time. Your partner should be given opportunities to show their talents. Discuss your partner’s abilities and suggest changes.