Healthcare Revenue Cycle Management – improving efficiency and profitability of healthcare providers worldwide

Sep 21, 2020

Posted In: Healthcare, patient payments Author: Uthaman Bakthikrishnan

RCM in India

The profit margins of healthcare providers in the advanced nations range from 2 to 4 percent of revenues. However, by outsourcing the revenue cycle management (RCM) operations, revenues have begun to rise to over 5% consistently for some providers.

RCM is the main constituent of the profitability of healthcare providers worldwide. Several companies in India specialize in RCM service, and most healthcare providers outsource their RCM work to the 200+ providers in India.

About 200K+ agents are providing RCM services in India, on behalf of healthcare providers from advanced nations.

RCM service bucket

Some of the critical aspects that RCM service providers handle include:

  • Patient eligibility checking for insurance claims
  • Electronic claim submissions
  • Clearance of claim denials and effective denial management
  • Management of accounts receivable
  • Avoiding problems with RCM like miscoded claims
  • Ensuring zero-accounts receivable balance

The entire billing and payment collection process is handled by the RCM service provider, which frees up the healthcare providers’ time and efforts to focus on patient care.

RCM service providers ensure the profitability of healthcare providers while shortening the revenue collection cycle time.

RCM challenges

While RCM service providers offer exemplary service, their existing systems and process did pose three significant challenges:

Agents call hold time is in the range of 40 minutes per call on average.

Manual entry of lengthy alphanumeric characters for claims processing was error-prone.

Inability to scale up and down the number of agent seats per the business demands. They were signing up for a fixed number of agent licenses.

Our platform

ClearTouch Connect’s on-demand RCM platform allows organizations to scale-up and down per their business demands in a moment’s notice. You pay only for what-you-use.

With our platform, you can reduce the agent call hold time to near zero, and you can automate alphanumeric character entry.

Our platform is built to remove all the challenges that the RCM service provider faces in its operations.

We have custom-built all of these features based on our experience of working with RCM service providers worldwide.

For More: Healthcare Contact Center Solution

CTC advantage

We help improve agent efficiency by three factors in the RCM industry, while the platform is pre-certified with HIPAA and ISO compliance. Our enterprise-grade RCM platform can be scaled easily.

About the Author: Uthaman Bakthikrishnan