RCM cycle is a must-implementation strategy by health facilities, that helps them generate revenue faster and manage their cash flow. The cycle involves the entire medical procedure, from patient verification to creating and sending bills.
But sometimes due to a lack of resources or staff, hospitals opt for collaborating with companies that manage their RCM cycle by implementing the suitable strategies.
If you too are a healthcare facility and want to know which company to choose for your RCM needs, look no further. As our guide has collected more than 170 companies that you can consider working with in 2024.
However, besides picking the best RCM cycle company there are other things that you must consider before collaborating with them.
Why Do Most Healthcare Outsource Their RCM Cycle?
Ever wonder why large practices despite containing extensive staff, still outsource their RCM to other firms?
The reason behind this is that medical bill and claim management should be conducted in a careful way, as it determines the reimbursement rejection or approval.
Hence, healthcare facilities that have a large patient base, outsource RCM cycle to avoid hard work. This way they can focus on other important health tasks to upscale their services.
Let’s compare outsourced RCM processes versus managing them in-house.
Aspect | Outsourcing RCM | In-House RCM |
Cost | Fixed monthly fees, potential cost savings | Higher initial investment, ongoing expenses |
Expertise | Access to specialized skills and knowledge | Direct control over staff and processes |
Scalability | Ability to scale services based on needs | Limited scalability without additional resources |
Control | Less control over processes and workflows | Full control over operations and decision-making |
Focus | Allows focus on core healthcare operations | Requires allocation of resources to RCM tasks |
Besides all this, there are some other benefits as well that healthcare facilities acquire when handover their RCM cycle to a company:
Error Reduction
Managing claims in-house multiplies the chances of containing claim errors, that result in claim denials and eventually revenue loss. Thatโs where RCM cycle companies come in.
They prepare and send claims incorporating accurate guidelines of insurance payers, that are more likely to be accepted.
Also, they keep a regular follow-up with the claim application so that they can remove any payer objection ASAP and help you generate quick revenue.
Technology Implementation
To conduct the RCM cycle effectively, modernized systems are used, which some health facilities canโt afford.
Additionally, keeping up with evolving RCM trends can be a daunting task for hospitals, and if ignored can lead to decreased financial stability.
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RCM companies take up your duties. They have already such systems and technology installed in their procedures that help them perform proficient revenue cycle management.
Training Hustles
Each health facility operates differently. When they hire the new staff they have to conduct proper training to let employees know how the system works.
However, if you donโt have time and training programs available in your hospital, go for RCM cycle companies. As they have already trained, skilled and professional teams that transform each of your claims into complete revenue.
Claim Tracking
Claim applications once created and sent must be reported regularly. This reporting helps identify denial patterns that assist in better future performance.
If you canโt keep a regular record and want to focus on other health areas, RCM cycle companies do that too.
Due to their experience, they already know how to manage claim applications. They avoid past mistakes that led to claim denials, and based on your data, they prepare future claims with full accuracy.
RCM Companies Can Save You Cost At…
Companies that specialize in revenue cycle management, or RCM, are essential in assisting healthcare providers with effective financial management.
Let’s examine how RCM businesses can help you save money on numerous fronts in your medical practice.
1. Efficient Billing and Claims Processing
The Healthcare Financial Management Association (HFMA) conducted research that found that RCM firms can cut back on billing and claims processing errors by up to 50%.
This degree of effectiveness guarantees timely claim filing, resulting in quicker insurance company payments and saving your practice important time and money.
2. Reducing Claim Denials and Rejections
According to the American Medical Association (AMA), a healthcare practitioners may lose 5โ10% of their annual revenue as a result of claim denials.
Insurance laws and regulations are a specialty of RCM cycle firms. They can prevent denials and rejections by thoroughly evaluating claims, thus protecting your practice from lost revenue.
3. Optimizing Revenue Collection
Medical Group Management Association (MGMA) study results show that RCM firms have assisted healthcare providers in increasing their revenue collection by an average of 15-20%.
RCM businesses make sure that your practice receives the money it is due by tracking down unpaid or underpaid claims and spotting payment anomalies.
4. Identifying and Correcting Coding Errors
According to the Journal of AHIMA (American Health Information Management Association), coding errors might result in a 10% revenue loss.
The expert coders used by RCM businesses meticulously analyze medical paperwork to ensure accurate coding and reduce revenue loss brought on by coding-related problems and compliance mistakes.
5. Improving Patient Payment Processes
According to a study in the Journal of Medical Practice Management, providing patients with convenient payment choices can improve patient payments by 30%.
To make it simpler for patients to pay their bills and lessen the stress of unpaid patient balances, RCM businesses offer online payment portals and convenient and flexible payment plans.
6. Minimizing Administrative Costs
According to the Medical Group Management Association (MGMA), healthcare organizations can save their administrative costs by up to 30% by outsourcing RCM services to specialized businesses.
You can save money by utilizing the knowledge and resources of RCM cycle businesses rather than spending money on pricey software or hiring more people just to handle billing and revenue management duties.
7. Enhancing Financial Predictability
Healthcare providers who partnered with RCM businesses reported a 20โ30% increase in financial predictability, according to a RevCycle Intelligence survey.
RCM firms help you predict your cash flow more precisely, making it simpler to plan and make investments in the expansion of your practice. They do this by optimizing revenue collection and automating billing procedures.
RCM Companies To Consider In 2024
Among a number of RCM cycle management companies, we have compiled the top ones. Based on your location and state, pick any of them:
3M HIS (Salt Lake City)
Abax Health (Westport, Conn.)
Accenture (Dublin, Ireland)
Access Healthcare (Dallas)
Access TeleCare (Dallas)
AccessOne (Charlotte, N.C.)
Accuity (Mount Laurel, N.J.)
AccuReg (Mobile, Ala.)
ACI Worldwide (Naples, Fla.)
AdvantEdge Healthcare Solutions (Lombard, Ill.)
Advantmed (Irvine, Calif.)
Advantum Health (Louisville, Ky.)
Advata Inc. (Bellevue, Wash.)
AGS Health (Washington, D.C.)
AIE Medical Management (Washington, D.C.)
AKASA (San Francisco)
All Right Medical Management Services (Chester, Va.)
Alvaria (Atlanta)
Americollect (Manitowoc, Wis.)
Amitech Solutions (St. Louis)
ANI Healthcare Solutions (San Francisco)
AnnexMed (East Brunswick, N.J.)
Anthro Innovations (Burbank, Ill.)
ApexonHealth (Southfield, Mich.)
ApprioHealth (Washington, D.C.)
Aspirion (Columbus, Ga.)
BC Services (Longmont, Colo)
BDO USA (Chicago)
BillingParadise (Diamond Bar, Calif.)
Boncura Health Solutions (Downers Grove, Ill.)
Cantata Health Solutions (Austin, Texas)
Capio (Lawrenceville, Ga.)
CareCloud (Somerset, N.J.)
CareCredit (Costa Mesa, Calif.)
CarePayment (Nashville, Tenn.)
Cascade365 Family of Companies (Petaluma, Calif.)
CBOSS (Boardman, Ohio)
Cedar (New York City)
Centauri Health Solutions (Scottsdale)
Change Healthcare (Nashville, Tenn.)
Cimcor (Merrillville, Ind.)
CIPROMS (Indianapolis)
Cirius Group (Pleasant Hill, Calif.)
Civxdata (San Diego)
ClaraPrice (Austin, Texas)
ClearBalance (San Diego)
ClinIntell (Seattle)
CodaMetrix (Boston)
CodeOne (Monument, Colo.)
Cognizant RCM (Teaneck, N.J.)
Collect Rx (Bethesda, Md.)
Collection Licenses (Irvine, Calif.)
CommerceHealthcare (Kansas City, Mo.)
Commure (San Francisco)
Commvault (Tinton Falls, N.J.)
Conifer Health Solutions (Frisco, Texas)
DaisyBill (Claymont, Del.)
Dimensional Insight (Burlington, Mass.)
Dolbey (Concord, Ohio)
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eCatalyst Healthcare Solutions (Phoenix)
Echelon Medical Capital (Delray Beach, Fla.)
Eclat Health Solutions (Herndon, Va.)
Edifecs (Bellevue, Wash.)
Elevate Patient Financial Solutions MedData (Spring, Texas Houston)
EMPClaims Solutions Inc (Lombard, Ill.)
Enable Healthcare (Hanover, N.J.)
EnableComp (Franklin, Tenn.)
Encore Exchange (Winston-Salem, N.C.)
Ensemble Health Partners (Mason, Ohio)
eSentire, Inc. (Waterloo, Ontario)
Excalibur (Grand Junction, Colo.)
Experian Health (Franklin, Tenn.)
Experity (Machesney Park, Ill.)
Fathom (San Francisco)
FCI/RevCare (Fairlawn, Ohio)
FTI Consulting (Brentwood, Tenn.)
Fathom (San Francisco)
FinThrive (Alpharetta, Ga.).
Finvi (Muncie, Ind.)
Flywire (Boston)
FrontRunnerHC (Plymouth, Mass.)
Frost-Arnett (Nashville, Tenn.)
Fusion Anesthesia Solution (Brookfield, Wis.)
GBS Corp. (North Canton, Ohio)
GeBBS Healthcare Solutions (Culver City, Calif.)
GetixHealth (Sugar Land, Texas)
Global Healthcare Resource (Atlanta)
Global Recovery Alliance AG (Baar, Switzerland)
Grant Thornton (Chicago)
Greenway Health (Tampa, Fla.)
Guidehouse (Chicago)
Hansei Solutions (Franklin, Tenn.)
Harmony Healthcare (Tampa, Fla.)
Harmony Healthcare IT (South Bend, Ind.)
Harris & Harris (Chicago)
Healogics (Jacksonville, Fla.)
Health iPASS, a Sphere Company (Oak Brook, Ill.)
Healthcare Claims Management (Indianapolis)
Healthcare IT Leaders (Alpharetta, Ga.)
Healthcare IP (Edmond, Okla.).
Healthcare Receivables Group (Knoxville, Tenn.)
Healthcare Resource Group (Spokane Valley, Wash.)
HealthPay24 (Mechanicsburg, Pa.)
HealthRise (Southfield, Mich.)
IC System (St. Paul, Minn.)
Imagine Software (Charlotte, N.C.)
Impact Advisors (Naperville, Ill.)
In2itive (Overland Park, Kan.)
Inbox Health (New Haven, Conn.)
Infinx (San Jose, Calif.)
InfoTech Healthcare (Denver)
Ingenious Med (Atlanta)
Innovaccer (San Francisco, Calif.)
Inovalon (Bowie, Md.)
InstaMed (Philadelphia)
Janus (Chicago)
Jive Software (Campbell, Calif.)
Kemberton (Franklin, Tenn.)
KeyBridge (Lima, Ohio)
Knack Global (Woodbridge, N.J.)
Knowtion Health (Boca Raton, Fla.)
KPMG (New York City)
L J Ross Associates, Inc. (Jackson, Mich.)
Lifepoint Informatics (Glen Rock, N.J.)
Lightning Bolt Solutions (San Francisco)
Managed Resources (Long Beach, Calif.)
MC AnalyTXs (Houston)
Medaptus (Boston)
Medasource (Indianapolis)
MedAssist (Louisville, Ky.)
MedeAnalytics (Richardson, Texas)
MedEvolve (Little Rock, Ark.)
Medfinancial (Knoxville, Tenn.)
Medical Consults, LLC (Stamford, Conn.)
Medical Payment Exchange (Rockville, Md.)
Medical Practice Success (Texarkana, Texas)
Medkoder (Mandeville, La.)
National Medical Billing Services (St. Louis)
Nemadji (Bruno, Minn.)
Netsmart (Overland Park, Kan.)
Ni2 Health (Bothell, Wash.)
Nordic (Madison, Wis.)
Nordis Technologies (Coral Springs, Fla.)
Nuance (Burlington, Mass.)
Nym (New York)
Olive (Columbus, Ohio)
OM1 (Boston)
Omega Healthcare (Boca Raton, Fla.)
Oncology Revenue Services (Monroe, N.Y.)
Oncospark (Ashland, Ky.)
Oneview (Dublin)
Online Information Services (Winterville, N.C.)
Optum (Eden Prairie, Minn.)
OSG Diamond Healthcare Solutions (Carol Stream, Ill.)
P3 Healthcare Solutions (Ontario, Calif.)
Parallon (Nashville, Tenn.)
PatientFocus (Nashville, Tenn.)
Patientory (Atlanta)
PatientPay (Durham, N.C.)
PatientPoint (Cincinnati)
PayMedix (Milwaukee)
QGenda (Atlanta)
Quadax (Cleveland)
Quest Diagnostics (Secaucus, N.J.)
Qventus (Mountain View, Calif.)
R1 RCM (Chicago)
Raintree Systems (Temecula, Calif.)
RCM Enterprise Services/SCC Soft Computer (Clearwater, Fla.)
RCMS (Cleveland)
Rectangle Health (Valhalla, N.Y.)
Redox (Madison, Wis.)
Regent Revenue Cycle Management (Westchester, Ill.)
Relatient (Franklin, Tenn.)
S&P Consultants (Braintree, Mass.)
Sagility (Westminster, Colo.)
Salucro (Phoenix)
Salud Revenue Partners (Lafayette, Ind.)
Savista (Alpharetta, Ga.)
Serbin Medical Billing (Fort Myers, Fla.)
Sherloq Solutions (Tampa, Fla.)
Signature Performance (Omaha, Neb.)
Simpler Consulting (Ottumwa, Iowa)
Sipi Asset Recovery (Elk Grove Village, Ill.)
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TailorMed (New York City)
Tanium (Kirkland, Wash.)
TechSolve (Cincinnati)
Tegria (Seattle)
Telcor (Lincoln, Neb.)
TigerConnect (Santa Monica, Calif.)
Titan Health Management Solutions (Tucson and Phoenix, Ariz.)
TransUnion (Chicago)
TriumpHealth (Southlake, Texas)
TriZetto Provider Solutions, a Cognizant Company (Earth City, Mo.)
TruBridge (Mobile, Ala.)
TrueRCM (Arlington Heights, Ill.)
Unified Health Services (Memphis, Tenn.)
United Collection Bureau (Toledo, Ohio)
Upfront Healthcare (Chicago)
USCB America (Los Angeles)
Verity IT (Downers Grove, Ill.)
Vee Technologies (New York City)
Ventra Health (Dallas)
VestaCare (La Jolla, Calif.)
VisiQuate (Santa Rosa, Calif.)
VitalWare (Yakima, Wash.)
Voluware (Huntington Beach, Calif.)
Vyne (Dunwoody, Ga.)
Wakefield & Associates (Aurora, Colo.)
Wave HDC (Tampa, Fla.)
Waystar (Louisville, Ky.)
Webdale Healthcare Consulting (Phoenix)
WebPT (Phoenix)
WhiteSpace Health (Boca Raton, Fla.)
The Wilshire Group (Sierra Madre, Calif.)
Windstream (Little Rock, Ark.)
Wolters Kluwer (Alphen aan den Rijn, Netherlands)
Workday (Pleasanton, Calif.)
XIFIN (San Diego)
XSOLIS (Nashville, Tenn.)
Xtend Healthcare (Hendersonville, Tenn.)
Yosi Health (New York)
Zayo (Boulder, Colo.)
Zotec Partners (Carmel, Ind.)
Zync (Carrollton, Ga.)
What Things To Look For In An RCM Firm?
Though all firms mentioned here are professional and expert in conducting the RCM cycle, there are still criteria that every RCM firm needs to satisfy.
In order to consider any organization to collaborate with, here are the following things to make sure of:
- First, you must research how many years a company has been providing its RCM cycle services. The more the years, it means the more knowledge and expertise they have.
- Verify that the company you choose must have the original certificate of ISO 9001. This certificate proves the authority of a firm.
- You must also ensure how many clients they have worked with in the past and their satisfaction level. This refers to their portfolio. Check the number of customers they have served and how they helped them in routine RCM cycle tasks.
- Another important thing to make sure of is a firmโs claim denial ratio. We know no one is going to provide you with accurate data about their claim denials, as it can harm their reputation. But it is still crucial to get denial the data in hand.
- Meet the team that will work on your RCM cycle and claims. Make sure they have enough skills and experience to handle your tasks.
- Last but not the least, you must consider the fees of a firm before signing the contract. Compare various RCM cycle companies and choose one that offers the most reasonable package.
The Future of RCM Cycle Companies: Predictions and Innovations for 2024 and Beyond
The Revenue Cycle Management (RCM) industry is positioned for new breakthroughs and technologies that will reshape the way healthcare is billed in the future.
RCM Cycle Companies are anticipated to be crucial in optimizing medical billing procedures and improving patient experiences in 2024 and beyond.
Here are some key performance indicators (KPIs) that are already used to measure the efficiency of RCM but will be more crucial in future:
Performance Metric | Description |
Clean Claim Rate | Percentage of claims submitted without errors or rejections |
Days in Accounts Receivable | Average number of days it takes to collect payments |
First Pass Resolution Rate | Percentage of claims resolved on the first submission attempt |
Collection Rate | Percentage of billed charges collected from payers and patients |
Denial Rate | Percentage of claims denied by payers |
Accounts Receivable Turnover | Frequency of converting outstanding AR into cash |
Patient Payment Collection Rate | Percentage of patient balances collected |
Let’s look at some of the most important forecasts and developments that are expected to influence their future.
Integration of Artificial Intelligence (AI)
RCM Cycle Companies utilize AI to automate monotonous operations like processing claims and payment follow-ups. AI algorithms are going to be advanced, which will result in quicker and more precise billing processes.
Predictive Analytics for Revenue Optimization
These companies will use predictive analytics to examine past data. This way they will estimate revenue trends and spot potential billing difficulties before they arise.
Healthcare providers’ revenue streams will be optimized by this proactive strategy.
Telehealth Billing Solutions
RCM cycle companies will provide specialized billing options for virtual care as telehealth services continue to expand.
They will guarantee smooth invoicing procedures for remote medical services and telehealth consultations.
Enhanced Patient Communication and Education
These firms will prioritize enhancing patient education and communication about medical billing. Patients are better able to grasp their financial obligations and make wise decisions if there is open and honest communication.
Data Security and Privacy Measures
RCM companies will invest in robust security measures as data breaches become a concern to protect patient information and guarantee adherence to privacy laws.
Mobile Billing Solutions
RCM Cycle companies will create cutting-edge mobile billing applications that will let patients effortlessly access billing data, make payments, and track claims through their cell phones.
Integration with Electronic Health Records (EHRs)
RCM companies will access patient data quickly. They will streamline billing procedures thanks to the increasing prevalence of seamless connectivity with EHR systems.
Personalized Billing Services
In order to provide specialized billing services that meet the specific demands of each healthcare provider, these companies will base their offerings on those needs.
Sustainability Initiatives
Some RCM companies will employ eco-friendly billing systems. This way they will reduce their use of paper in order to contribute to environmental preservation.
AI-Powered Denial Management
Denial management solutions powered by AI will effectively identify and address claim denials, minimizing reimbursement processing times and maximizing revenue flow.
Your Guide To Choosing An RCM Company
With the help of our detailed guide, you are now in a better position to pick an RCM cycle management company that not only manages your claims but also helps you secure adequate revenue.