Strategic Planning Improves Revenue Cycle Management


Choosing the right partner to deliver strategic value to RCMRevenue Cycle Management (RCM) is an important aspect of any healthcare business. It involves processes that ensure that patients are afforded the right healthcare treatments and are billed accurately, while healthcare service providers are paid by patients and reimbursed accordingly by insurance companies.

Revenue cycle management functions such as front and back office services, accounts receivable and denial management, and other non-medical patient services ensure that there is continuous revenue flowing into your healthcare practice.

Why outsourcing revenue cycle management is necessary

In a study conducted by Grand View Research, the global RCM market is expected to be worth $65.2 billion by 2025. Healthcare services are projected to grow at a CAGR of at least 11%, while particular services such as accounts receivable and denial management are expected to be highly outsourced within the next eight years.

With a rapidly changing economy, achieving sustained growth can be a challenging feat when faced alone. These days, working with an efficient outsourcing solutions partner is a smart and practical way of working towards a secure and sustainable future.

While there is a promise of growth within the RCM market in the coming years, healthcare practices without the right RCM partner may experience revenue cycle management challenges that could result in increased or unnecessary spending caused by the tremendous pressure to keep up with industry trends and global competitors.

For example, managing RCM, in-house, will require you to spend for real estate, infrastructure, payroll, supplies, software and technologies, and manpower to fulfill the operating requirements of your team. These operational expenses can pile up and significantly pull down profit, creating a domino effect, bringing both operational capacity and service levels down along with it.

Furthermore, the following red flags should also immediately prompt you to consider partnering with an RCM solutions provider:

  • Recurring tardiness in claims submissions
  • Inaccurate medical coding which could result in audits
  • Constant patient complaints regarding inefficient reimbursements
  • Late billing of patients and sluggish posting of payments to patient accounts
  • Exceedingly high operational costs
  • High staff turnover and poor employee performance
  • Lack of proper denial management

Such RCM concerns can significantly decrease patient satisfaction and the overall credibility of your healthcare practice. Without the right people, mindset and tools, your healthcare business can experience substantial profit loss and prevent you from delivering the premium care that your patients deserve.

Choosing the right RCM solutions partner

We at ADEC Innovations Healthcare understand the role of RCM as a crucial administrative function in your healthcare practice. Partnering with us means your business’ non-core competencies will be handled by professionals who possess a deep understanding of technology solutions and services rooted in sustainability, data management and extensive industry knowledge.

Our customized end-to-end solutions can address the specific requirements of your healthcare business allowing you to cut down on costs, manage and allocate funds and resources efficiently, lower operational inefficiencies, decrease high staff turnover, improve denial management, and reduce medical coding and billing inaccuracies.

Equipped with 30 years’ of healthcare experience and expertise in healthcare information management, we possess the capabilities needed to deliver strategic value to RCM. Through our customizable and scalable solutions, clients can expect the following:

  • 30%-40% reduction in labor costs
  • A turnaround time compliance rate of 100% in all deliverables
  • An annual coding accuracy rate of 98% per 120,000 charts
  • AAPC and AHIMA certified medical coders with minimum of 3 years’ experience

We also guarantee HIPAA-compliant processes and facilities, as well as highly secure operations that ensure the confidentiality of your patient records. Furthermore, we diligently track regulatory changes to ensure compliance at all times.

ADEC Innovations Healthcare offers customizable and integrated solutions that are responsive to the dynamic requirements of the healthcare industry. We offer a broad portfolio of solutions and services that place sustainability at the heart of healthcare operations. Contact us for more information about how we can help significantly improve your healthcare business’ RCM.