Does Outsourcing Revenue Cycle Management Work?

The sheer volume of new revenue cycle management firms shows providers’ continued migration to outsourcing revenue cycle functions. Full revenue cycle outsourcing, when implemented with revenue cycle partners can be a winning strategy that transforms a medical facility into a sustainable, high-performing engine. The need for experts in each of the revenue cycle functions allows facilities to choose to outsource partial or full revenue cycle responsibility.

What is driving providers to “farm out” hospital revenue cycle, billing and collecting services? As providers develop keen expertise to set themselves apart from others, so do revenue cycle professionals. The trend in outsourcing is being led by the availability of expertise in all areas of revenue production. If DRG validation needs addressing it would make sense to hire a firm with physician expertise in finding the correct DRG for all billing.

“Provider organizations investing in outsourced revenue cycle services to relieve cost and resource burdens need their firms to take true ownership of the complex revenue cycle and deliver accordingly,” KLAS stated in a recent report. “Unfortunately, some firms are falling short—most common for clients using full revenue cycle outsourcing (RCO).”

FairCode combines the domain expertise of experienced physicians with modern data science and analytics technologies to increase hospital revenue. We bridge the gap between your attending physicians and hospital coders. The result? Patient acuity and Case Mix Index are more accurately captured with the correct DRG; hospital reimbursement adjusts accordingly. DRG Validation and physician conducted medical chart reviews happen in real time, significantly impacting hospital quality rankings, case mix index (CMI) and bottom-line results. From clinical validation and chart reviews to payor denial defense, our physicians and data scientists are part of your team! Add us to your existing CDI initiatives, and see the difference. Outcomes are measurable and significant. FairCode averages greater than 4:1 Gross Return on Investment in client hospitals, and has been delivering hospital revenue solutions for over 18 years.