Revenue Cycle Management – Outsourcing Trends and Benefits

The complexities in hospital billing continue to haunt hospital revenue management professionals. Like medicine, specialists are the preferred player when it comes to the nuances of revenue management. Some hospitals have outsourced their entire revenue cycle due to the complexity and interdependence of all aspects of revenue cycle. The adoption of various alternative models for payment as well as regulatory intervention lead a hospital’s revenue cycle department to hire specialists trained in coding and collecting revenue.

A recent study undertaken by the Black Book showed up to 80% of the hospitals in the US are in various stages of the process of outsourcing, vetting and hiring roles within the revenue cycle. For instance, outsourcing physician coders to code the right DRG the first time increases hospital revenue and decreases denials. Further, up to 20% of all uncollected hospital payments are due to improper or incomplete coding.Before choosing an RCM outsourcing partner, the hospital must do its due diligence on the proposed vendor.How long has the vendor been in business? Are there three or more hospital references from actual customers? What are some real-time examples where outsourcing to this vendor financially benefitted a hospital?

FairCode has been in business for 19 years with over 1.5 million cases reviewed to date. We combine the domain expertise of experienced physicians with modern data science and analytics technologies to increase hospital revenue. FairCode bridges the gap between a hospital’s attending physicians and hospital coders. The result? Patient Acuity and Case Mix Index are more accurately captured with the correct DRG, and hospital reimbursements adjust 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, FairCode’s physicians and data scientists are part of a hospital’s coding team. Add FairCode to your existing CDI initiatives and see the difference. Outcomes are measurable and significant. FairCode averages greater than 4:1 Gross Return on Investment.

http://www.faircode.com/