Healthcare revenue cycle management (RCM) is a financial process, which contains a series of complex steps such as charge entry, claim checking, patient scheduling, and insurance verification. Additionally, the healthcare RCM includes patient statements quality & audit, medical coding services, payment processing, denial management, and customer follow up. Several companies prefer to outsource these services due to the complex nature of these processes. Medical billing is a crucial process due to the rise in healthcare expenditure, use of information technology, Internet use, and high need for risk and agreement management. However, RCM outsourcing helps healthcare organizations to save time by automating the responsibilities and overcoming the errors or challenges, which were previously handled/faced by employees. In healthcare revenue cycle management (RCM) outsourcing market, analytical tools used by service providers to monitor, track, and analyze patient data to finds meaningful insights related to disease and abnormalities. Healthcare RCM helps in various aspects such as converting medical services into billable charges, claim submissions, determining patient balances, and collecting payments. Furthermore, outsourcing healthcare RCM helps in collecting preregistration information, remittance processing, collecting payments from third-party insurers, and examining the necessity of medical services. Healthcare RCM outsourcing reduces costs of end-users. Other benefits include doctors have a better control and understanding of their revenue cycles, which helps them enhance their financial processes. The healthcare revenue cycle management outsourcing market creates lucrative opportunities for healthcare solutions providers. Rising demand for healthcare RCM outsourcing is projected to help solution providers expand their market share by providing tailored RCM solutions possessing capabilities such as operational excellence and a sophisticated approach. RCM system provides efficient workflow processes with higher output through the use of automated and manual solutions.
Governments have implemented stringent rules and regulations over the last few years due to the rise in number of issues in the healthcare sector such as increase in the operating costs of healthcare facilities and medical billing processes. Additionally, increasing industrialization and urbanization rates and rapid rise in prevalence of diseases across the globe are driving the healthcare revenue cycle management (RCM) outsourcing market. Growth of the health insurance coverage sector is expected to increase the number of processes such as reimbursements and denials. Therefore, the demand for advanced systems such healthcare RCM is projected to increase in the near future.
Development of advanced technologies such as blockchain, machine learning, and artificial intelligence is anticipated to boost the healthcare revenue cycle management outsourcing market to improve healthcare quality and smoothen processes and create opportunities for healthcare facilities such as automated medical billing and virtual healthcare. However, factors such as limited use of healthcare RCM, high implementation cost, rising financial challenges, and complex structure of healthcare RCM are likely to restrain the global healthcare revenue cycle management outsourcing market during the forecast period.
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The healthcare revenue cycle management (RCM) outsourcing market can be segmented into type, component, end-use, and region. In terms of type, the healthcare revenue cycle management (RCM) outsourcing market can be classified into pre-intervention, intervention, and post-intervention. Based on component, the h healthcare revenue cycle management (RCM) outsourcing market can be bifurcated into software and services. The software segment can be sub-segmented into on-premise and cloud. In terms of end-user, the healthcare revenue cycle management (RCM) outsourcing market can be segregated into hospitals, diagnostic laboratories, physician back offices, and others. Based on region, the global healthcare revenue cycle management (RCM) outsourcing market can be divided into North America, South America, Europe, Asia Pacific, and Middle East & Africa.
Key players operating in the global healthcare revenue cycle management (RCM) outsourcing market include Conifer Health Solutions LLC, Emdeon Business Services LLC, MedAssets, Inc., McKesson Corporation, Parallon Business Solutions, LLC, SSI Group, LLC, Nthrive Solutions, LLC, Optum, Inc., Vee Technologies, Change Healthcare, MedData, Inc., Availity, LLC, R1 RCM Inc, and GeBBS Healthcare Solutions and Cerner Corporation.
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