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Revenue Cycle Management (as-a-Service)

Turning the tables on insurance claims denials.

As the healthcare industry continues to grapple with claims denials, Revenue Cycle Management (RCM) experts and investors have formed an alliance with software providers to come up with an innovative solution to the problem: RCM-as-a-Service. It's a new concept that offers healthcare providers the ability to improve their claims recovery without investing large amounts of time and money.

What is "Revenue Cycle Management?" Revenue Cycle Management (RCM) is the process of managing the financial aspects of a healthcare organization's relationship with patients, from their first appointment to their final payment. It includes tasks such as patient registration, charge capture, coding and billing, claims management, and payment posting. The goal of RCM is to optimize the revenue generation of a healthcare organization by ensuring that all services rendered are properly documented, coded, and billed, and that payments are collected in a timely manner.

RCM-as-a-Service is a partnership between the healthcare provider and the service provider. It is not a complete handover of responsibility to the service provider. Rather, it is a collaboration between the provider and the service provider to achieve the common goal of improving claims recovery. By leveraging advanced A.I. tools and expert human resources, healthcare providers can increase their claims collections by 5 percent or more. Doing the math, for a $1 Billion healthcare provider, 5% would equal a revenue gain of $50 Million.

Insurance providers deal in money. That's their business. And as such have barrels of money for technology designed to find mistakes in claims and deny them. Healthcare providers deal in the health of their patients and all that goes with it, i.e. facilities, doctors, nurses, staff, tools, etc. Spending more money on technology and back office HR is not something that's done freely.

One of the most attractive aspects of RCM-as-a-Service is the payment model. Providers pay nothing upfront. Instead, the service provider is compensated based on the increase in revenue that results from improved claims recovery. For that, they bring proven, winning executives who've been-there/done-that. Plus the technology know-how and software so that the client is fighting a fair fight. It's a win-win situation for everyone involved.

We believe that RCM-as-a-Service is a game-changer for healthcare

providers who are tired of constantly dealing with claims denials. It's a proven solution that is backed by experts in the field. If you're interested in learning more about how RCM-as-a-Service can benefit your organization, we will be happy to provide a referral. email

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