With the increasing demand for medical billing in healthcare, some of the top revenue cycle management companies are operating and providing their RCM services to help you generate greater revenue.
But why it is essential to hire top RCM companies when you could carry out medical coding yourself?
The answer is that you must rely on professional hospital revenue cycle management companies to execute medical billing and coding as any minor mistake can lead to the claims being rejected by the payer, which in turn, weakens your financial stability.
Healthcare revenue cycle management companies can deal with the entire revenue generation process, so you can focus on other responsibilities besides getting your revenue.
In fact, HFMA conducted a survey in 2023, where they found that hospitals collaborating with RCM firms experienced 8% yearly revenue increase from the last 3 years, which was 6% more than conducting in-house billing.
So why not try these companies out?
Different RCM Models
Revenue cycle management ensures that healthcare providers’ financial operations run smoothly in the constantly changing environment. RCM is the process of overseeing the financial facets of patient care, from claim filing and payment to registration and billing.
To build payment agreements and reimbursement processes within RCM, many models are used. In order to maximize financial results, let’s examine the various RCM models:
Fee-for-Service Model
One of the classic methods of paying for healthcare is the fee-for-service model. The services that healthcare practitioners offer to patients determine how much they are compensated under this paradigm.
Each service, whether a visit to the doctor, an operation, or a diagnostic test, has a set cost. Each service that is given by a provider is billed, and the provider is paid back for that amount.
Value-Based Care Model
Value-based care is a more recent RCM approach that places more emphasis on the standard of care given to patients than on the volume of services delivered.
According to this paradigm, incentives for healthcare providers are based on patient outcomes and improvements in the general health of the population they serve.
Through preventative treatment and efficient disease management, the objective is to improve patient outcomes and save healthcare expenditures.
Bundled Payment Model
A single payment is paid to healthcare providers under the bundled payment model for a full episode of care. Providers receive a flat payment for all services connected to a certain treatment rather than separate payments for each service.
This model seeks to advance cost-effectiveness and care coordination.
Separate Healthcare RCM Settings
In order to guarantee that healthcare professionals are fairly compensated for their services, revenue cycle management (RCM) is an essential procedure.
RCM is not a one-size-fits-all strategy, though. The healthcare environment, such as hospitals, clinics, and doctor’s offices, has a substantial impact on it.
Let’s talk about the variations in revenue cycle management (RCM) across these various healthcare settings and how it works for each.
RCM for Hospitals
Hospitals deal with a variety of services and complex patient problems, necessitating a strong and thorough approach to RCM.
Coordination is crucial since hospital billing and coding procedures include numerous departments and service lines. To maximize healthcare revenue capture, RCM places a strong emphasis on swift claims processing, precise coding, and detailed documentation.Â
Furthermore, hospitals frequently have increased claim denials because of the volume and complexity of the services they offer, making denials management essential.
For the purpose of maximizing revenue collection, RCM teams concentrate on prompt claim follow-up and appeals.
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RCM for Clinics
Whether specialized or broad, clinics frequently cater to a particular patient demographic. It can provide a more constrained range of services than hospitals.
RCM for clinics emphasizes patient involvement and open billing. Efficiency in claim filing and payment posting is essential given that clinics frequently manage a higher volume of outpatient appointments.Â
To increase patient satisfaction, RCM teams in clinics place a high priority on prompt patient billing.
They provide a variety of payment choices. As a result of clinics’ smaller size compared to hospitals, RCM may be less complicated, making it easier to administer for internal teams or outside RCM services.
RCM for Physician Practices
In comparison to hospitals and clinics, physician practices may serve a smaller patient population. They usually concentrate on providing specialized medical care.
RCM for physician practices entails close collaboration between medical staff and the billing department. For timely reimbursement and to avoid claim denials, accurate billing and coding are crucial.
To reduce administrative burdens and improve revenue collection, many medical practices outsource their RCM to top revenue cycle management companies.
To maintain a steady cash flow, RCM teams for medical practices frequently concentrate on personalized patient billing and diligent follow-up.
Top Revenue Cycle Management Companies
Here are 16 of the top revenue cycle management companies that we have picked along with defining their location, staff quantity, and revenue generated in the past.
General Electric Company
Location: Boston Staff
Quantity: 168,000
Past Revenue: $74.196 Billion
The General Electric Company (GE) is a global leader in various industries, including healthcare. With a substantial staff size and a proven track record of generating significant revenue, GE has established itself as a trusted partner in revenue cycle management.
Their expertise spans across the entire RCM process, from accurate coding and claims submission to effective denial management and revenue optimization.
Siemens Healthineers
Location: Erlangen
Staff Quantity: 66,000
Past Revenue: $22.32 Billion
Siemens Healthineers is renowned for its cutting-edge technologies and solutions in the healthcare industry. With a sizable staff and impressive revenue figures, they bring a wealth of expertise to the field of revenue cycle management.
Siemens Healthineers offers comprehensive RCM services that encompass coding accuracy, claims processing, and revenue optimization.
Their advanced technology platforms and analytics capabilities enable healthcare organizations to streamline their RCM processes, reduce denials, and enhance financial outcomes.Â
Epic Systems
Location: Verona
Staff Quantity: 10,000
Past Revenue: $2.9 Billion
Epic Systems is a leading provider of healthcare software solutions, including its renowned electronic health record (EHR) system. While they primarily specialize in EHR technology, Epic Systems also offers robust revenue cycle management services.
With a dedicated team and a focus on seamless integration between clinical and financial workflows, Epic Systems ensures accurate coding, efficient claims processing, and improved revenue capture.
Their user-friendly interface and comprehensive reporting capabilities empower healthcare organizations to monitor their revenue cycle performance and make data-driven decisions for continuous improvement.
Cerner Corporation
Location: Kansas City
Staff Quantity: 29,000
Past Revenue: $5.7 Billion
Cerner Corporation is a trusted name in the healthcare IT industry, offering a wide range of solutions to support various aspects of healthcare operations.
Their expertise extends to revenue cycle management, where they provide comprehensive services designed to optimize financial performance.Â
Their integrated approach allows for seamless coordination between clinical and financial systems, enhancing efficiency and ensuring accurate reimbursement.
Quest Diagnostics
Operates Nationwide
Staff Quantity: 47,000
Past Revenue: $7.73 Billion
Quest Diagnostics is a nationwide leader in diagnostic testing and clinical laboratory services. While their primary focus is on laboratory testing, they also offer revenue cycle management services to healthcare organizations.
With a vast network of laboratories and a substantial workforce, Quest Diagnostics brings extensive experience in managing billing processes and maximizing revenue.
Their RCM solutions encompass accurate coding, efficient claims submission, and proactive denial management.Â
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McKesson Corporation
Location: Texas
Staff Quantity: 78,000
Past Revenue: $263.97 Billion
McKesson Corporation is a prominent player in the healthcare industry, offering a wide range of services and solutions to healthcare organizations.
With a significant staff size and impressive revenue figures, McKesson Corporation has established itself as a trusted partner in revenue cycle management.Â
They provide comprehensive RCM services, including accurate coding, claims management, denial prevention, and revenue optimization.
Through its advanced technology platforms and analytical capabilities, McKesson Corporation helps healthcare providers streamline their revenue cycle, reduce inefficiencies, and enhance financial performance.
Accenture
Location: Dublin
Staff Quantity: 721,000+
Past Revenue: $50.53 Billion
Accenture is a global professional services company that specializes in providing innovative solutions across various industries, including healthcare.
With an extensive staff size and a strong financial track record, Accenture offers comprehensive revenue cycle management services tailored to the unique needs of healthcare organizations.Â
Their RCM solutions focus on process optimization, data analytics, and technology integration to drive efficiency and maximize revenue.
By leveraging its vast resources and expertise, Accenture enables healthcare providers to navigate the complexities of RCM and achieve sustainable financial growth.
Access Healthcare
Location: Florida
Staff Quantity: 20,000
Past Revenue: $2 Billion
Access Healthcare is a leading provider of revenue cycle management services, dedicated to helping healthcare organizations optimize their financial performance.
With a sizable staff and a focus on process excellence, Access Healthcare offers comprehensive RCM solutions that cover the entire revenue cycle, from patient registration to final reimbursement.Â
Their expertise in coding, claims management, denial prevention, and revenue recovery enables healthcare facilities to streamline their RCM processes and improve cash flow.
By partnering with Access Healthcare, organizations can benefit from their tailored solutions and industry best practices.
AccessOne
Location: North Carolina
Staff Quantity: 123
Past Revenue: $33.2 Million
AccessOne is a specialized revenue cycle management company that focuses on patient financial engagement and billing solutions.
Their unique approach combines compassionate patient care with innovative technology to optimize revenue collection and improve the patient’s financial experience.Â
With a dedicated team and a commitment to patient-centric solutions, AccessOne assists healthcare organizations in managing self-pay accounts, providing financial counseling, and optimizing collections.
By partnering with AccessOne, hospitals can enhance patient satisfaction, increase collections, and streamline their revenue cycle.
Abeo
Location: Dallas
Staff Quantity: 121,100
Past Revenue: $4.34 Million
Abeo is a leading provider of revenue cycle management services, specializing in anesthesia billing and practice management solutions. With a strong focus on the anesthesia specialty, Abeo brings deep expertise and tailored solutions to anesthesia providers.
Their comprehensive RCM services encompass coding accuracy, claims management, and revenue optimization specific to the unique challenges of anesthesia billing.
By leveraging their specialized knowledge and innovative technology, Abeo helps anesthesia providers improve revenue capture, reduce administrative burden, and enhance financial performance.
Beyond The 10 Top RCM Companies
Besides the leading RCM organizations, here we would like to provide 6 additional company names because of their remarkable services and popularity in the industry:
1. AthenaHealth
Location: Watertown, MA
Staff Quantity: 7,000
Past Revenue: $2.9 Billion
AthenaHealth is one of the top suppliers of cloud-based applications and services to healthcare providers. Your financial performance, productivity, and efficiency are all enhanced by their solutions.
Over 115,000 healthcare organizations in the US, including hospitals, health systems, and private clinics, use Athenahealth’s products.
2. Medline Industries
Location: Northfield, IL
Staff Quantity: 13,000
Past Revenue: $17.5 Billion
For healthcare providers seeking a one-stop shop for RCM services, medical equipment, and supplies, Medline Industries is a suitable option. They offer top-notch customer service and a broad variety of goods and services.
3. R1 RCM
Location: Irvine, CA
Staff Quantity: 2,000
Past Revenue: $1.0 Billion
R1 RCM is a leading provider of technology-enabled revenue cycle management (RCM) services.
With their solutions, providers may increase their revenue collection, decrease rejections, and streamline their billing procedures, all of which contribute to better financial performance.
4. Parallon
Location: Franklin, TN
Staff Quantity: 2,500
Past Revenue: $1.2 Billion
They provide a full range of services, such as coding, denial management, patient engagement, and claims processing. With the use of Parallon’s solutions, providers can increase their revenue collection, decrease denials, and streamline their billing procedures.
5. Envision Healthcare
Location: Nashville, TN
Staff Quantity: 48,000
Past Revenue: $10.5 Billion
Envision provides a variety of services like anesthesia care, ambulatory surgery, and physician staffing. In addition, Envision Healthcare is a top supplier of revenue cycle management (RCM) services to medical groups, hospitals, and health systems.
6. AGS Health
Location: Brentwood, Tennessee
Staff Quantity: 6900+
Past Revenue: $50 Billion
Offering comprehensive services for RCM, AGS Health provides a strong range of options to maximize each stage of the process. They provide medical coding, denial management, patient financial engagement, and claims processing.
Furthermore, AGS Health makes use of cutting-edge AI tech to spot and fix revenue leakage, guaranteeing that healthcare institutions receive all of the money they are due.
Use of Technology in RCM
Technology is revolutionizing RCM practices in the current fast-paced healthcare sector. Employing this is advantageous to both healthcare providers and patients. Let’s discover some of the advancements you can make or your RCM service provider will employ:
Electronic Health Records (EHRs)
The medical histories and treatment plans of patients are stored electronically in EHRs. By enhancing patient care coordination and streamlining data availability, they have revolutionized RCM.
With EHRs, healthcare professionals may easily access vital patient data. It reduces the need to trawl through paper records and improves the effectiveness of the billing procedure.
A healthcare facility’s various departments may easily communicate and update patient data thanks to the centralized and accessible nature of EHRs, which improves care coordination and teamwork.
Billing Systems
The foundation of revenue cycle management is billing systems, which fully automate the entire cycle. Billing solutions streamline and optimize the financial workflow.
It saves immense time and lowers manual errors, from claim creation through submission and payment tracking. This technology ensures that healthcare professionals are paid accurately and on time for the services they perform.
Data Analytics Tools
By analyzing massive information and offering insightful analyses and trends, data analytics technologies play a crucial part in healthcare revenue cycle management.
These RCM technologies assist healthcare providers in identifying opportunities for development and evaluating the financial performance of their businesses.
Expect Increased ROI when Partnering with RCM Companies
Financial security and operational effectiveness are essential for healthcare providers.
What is the return on investment (ROI) that providers can anticipate from collaborating with leading RCM firms? Revenue cycle management services are essential for guaranteeing efficient financial operations.
Let’s explore the benefits of RCM services and how they might assist healthcare providers in maximizing their profits.
1. Increased Revenue Collection
Revenue collection for healthcare providers can improve significantly as a result of collaboration with leading RCM firms.
Industry statistics show that when providers optimize their RCM with professional help, they can expect an average revenue growth of 5% to 10%.
Accurate claim filing, fewer denials, and prompt reimbursement processing are the causes of this increase in revenue.
2. Reduction in Operating Costs
Effective RCM services save administrative work and streamline financial procedures. According to studies, healthcare providers can save operational expenses by up to 20% by outsourcing RCM.
In addition to enhancing operational efficiency, this decrease in physical labor frees up resources for providers to devote to patient care and raises the standard of services as a whole.
3. Optimized Cash Flow
Healthcare providers benefit from an optimized cash flow thanks to prompt and accurate revenue collection, effective billing, and claims administration.
Research shows that when providers implement effective revenue cycle management solutions, their cash flow can improve by 15%. Providers may make wise financial decisions to improve their facilities when they have a predictable cash flow.
4. Improved Billing Accuracy
To assure billing accuracy, top revenue cycle management companies use cutting-edge billing technologies and electronic health information.
According to studies, putting in place an EHR system can cut down on billing errors by up to 86%.
The likelihood of claim denials and revenue loss due to billing errors is decreased as a result of the increase in billing accuracy, which also improves overall financial performance.
5. Enhanced Patient Satisfaction
Experiences with billing that are easy and clear have a favorable effect on patient satisfaction. Nearly 80% of patients who participated in patient surveys said they valued straightforward and accurate billing procedures.
RCM services that put the needs of the patient first produce happier clients who are more likely to refer other people to the healthcare provider, eventually boosting patient loyalty and retention.
Know the Importance of EHR in RCM
6. Efficient Denials Management
Leading RCM firms use proactive denials management techniques.
Up to 90% of claim denials, it is estimated by the industry, are avoidable. RCM professionals greatly minimize the number of claim denials through thorough denials management, resulting in fewer revenue losses and more successful claim resubmissions.
7. Data-Driven Decision Making
RCM services offer healthcare providers in-depth financial reports and analytics.
The Healthcare Financial Management Association (HFMA) conducted a study that found that providers who employ data analytics in their RCM reduce accounts receivable days by 5% and the cost of collection by 20%.
Data-driven insights assist providers find areas for development, maximize income production, and simplify financial processes so they can make well-informed decisions.
8. Enhanced Compliance and Risk Management
Top RCM firms place a high priority on adhering to industry standards and healthcare laws. The American Medical Association (AMA) estimates that billing and coding mistakes can jeopardize up to 30% of healthcare income.
RCM services protect financial stability by employing strict risk management procedures that lessen the possibility of penalties or fines for non-compliance.
9. Focus on Core Competencies
Healthcare providers may concentrate on their core competencies—providing high-quality patient care—by collaborating with top revenue cycle management companies.
RCM experts take care of complex financial procedures, freeing providers to focus on providing excellent care and ensuring patient satisfaction.
10. Long-Term Financial Stability
Healthcare providers who invest in RCM services are guaranteed long-term financial stability.
Nearly 80% of hospitals that outsource RCM reported improvements in their finances, according to a study by Black Book Research.
A stronger financial base for the organization may result from ongoing improvements in revenue collection and financial performance.
The Bottom Line
Choosing the right revenue cycle management company is a critical decision that can significantly impact the financial success of your healthcare organization.
By considering factors such as location, staff size, and past revenue figures, you can make an informed choice.Â
These top 15 revenue cycle management companies offer a range of expertise, services, and solutions to streamline your revenue cycle, optimize financial outcomes, and enhance operational efficiency.
By partnering with one of these reputable companies, you can focus on delivering quality healthcare while ensuring a healthier bottom line.
Faq’s
What are the top revenue cycle management companies we can rely on?
A- Although there are a number of RCM companies, based on our extensive research we have chosen the following best one from them:
- General Electric Company
- Siemens Healthineers
- Accenture
- Access Healthcare
- AccessOne
- Epic Systems
- Quest Diagnostics
- McKesson Corporation
- Abeo
- Cerner Corporation
What criteria to keep in mind when choosing a company?
A- The following are the criteria on the basis of which you should analyze and pick an RCM firm:
Experience: This is the first thing to keep in mind when choosing a company. See how many years of diversified experience they possess.
Expertise: Make sure the company masters and provides services to all the aspects of RCM.
Technology and software: The company must be able to use updated technology as the healthcare industry keeps changing.
Compliance: They must follow the industry rules and regulations.
Customization: The company must be able to adapt to your healthcare facility to serve your patients and insurance payers better.
Cost and pricing: Last but not least, you must ask for the monthly and yearly contract fees, along with any extra charges.
Are there different types of RCM companies? How do they differ?
A- Based on specialization, each company differs in the service they provide. The service areas that make each company unique are:
- Billing and Coding
- Accounts receivable management
- Eligibility verification
- Patient payment solutions
- Denial management
- Revenue cycle consulting
- Full RCM outsourcing