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Outsourcing Healthcare Payment Functions: Not Just for Banks Anymore, But Billers Too!

Outsourcing Healthcare Payment Functions: Not Just for Banks Anymore, But Billers Too!Healthcare providers are now outsourcing more of their revenue cycle functions. Large banks saw this medical banking potential several years ago and moved quickly to offer added-value services such as EOB conversion and treasury management capabilities specifically for this niche.

As many banks partnered with outsourced vendors, billers are jumping in to offer services such as the automated reassociation of electronic funds transfers (EFTs) and electronic remittance advices (ERAs). These new services feed healthcare billers with incremental revenue growth, stronger customer relationships and a counter balance to patient accounting and billing companies that include limited revenue cycle management functionality. Cloud-based solutions, like those offered by OrboGraph, make it easier than ever for billers to provide new solutions and comply with HIPAA/HITECH requirements.

The combination of increasing government regulation, declining reimbursements, and complex re-association requirements in a manual operations environment has more healthcare providers looking to offload resource-intensive revenue cycle functions to accelerate posting and capture more revenue. According to Modern Healthcare’s outsourcing survey, the top 20 healthcare outsourcing companies grew their businesses by 13.1 percent between 2010 and 2011. This trend will only grow as providers are pressured to reduce operating costs and deal with lower reimbursement rates.

Far more than commodity-priced transaction processing, this type of healthcare payments service positions healthcare billers to help reengineer a healthcare provider’s revenue cycle. Additionally, OrboGraph’s solutions address paper and electronic payments, allowing billers to capture revenue from transactions that may have bypassed their traditional paper-based services. Best of all, billers can generate a strong $1 to $2 per transaction, while creating stickier relationships with providers.

Reselling expanded revenue cycle services provides a biller’s clients with benefits such as:

  • Accelerated collections
  • Streamlined reconciliation
  • Improved Day’s Sales Outstanding (DSO)
  • Lower operating costs
  • Better processing accuracy
  • Increased visibility into receivables information
  • Reduced processing errors and write-off
  • Additional resources for providing patient care

Hungry for new revenue streams and a counter to new competitors, there’s never been a better time for billers to offer expanded outsourced revenue cycle services such as the reassociation of ERAs and EFTs.

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