Outsourcing revenue cycle management (RCM) is no longer just about offloading tasks. As shared by Chuck Rackley, Greenway’s Vice President of Sales and Revenue Operations, and Marvin Luz, Senior Director of Revenue Consulting, in a recent episode of the MGMA Business Solutions Podcast, the RCM landscape has evolved into something more strategic—and far more impactful.
Today’s practices face growing financial and operational pressures, from tighter reimbursement rates to staffing shortages and administrative burnout. In this environment, the right revenue services partner can provide scalable support, specialized expertise, and a more proactive approach to managing revenue cycles—helping practices protect their financial health while staying focused on delivering quality care.
RCM has evolved into a strategic partnership
“RCM today, it looks a lot different than it did even just a few years ago,” Rackley said. “It’s no longer just about sending out claims to a partner, hoping someone else handles it. What we’re seeing now is a much more strategic partnership.”
As staff turnover rises and payer requirements grow more complex, practices are seeking partners that bring scale, adaptability, and operational expertise. With the right support in place, providers can improve financial performance without compromising clinical focus. Learn more about how Greenway supports this approach through its revenue cycle management solutions.
The billing experience plays a key role in patient satisfaction
According to Luz, one of the most common sources of patient frustration is the billing process—specifically, unclear or delayed statements.
“They can be confusing, inaccurate, and not timely,” he said. “It’s imperative that patient statements are accurate, timely, and easy to understand.”
As high-deductible plans become more common, patients are taking on greater financial responsibility. Billing transparency, clarity, and empathy aren’t just administrative considerations—they’re essential to patient trust and loyalty. Luz emphasized the value of working with a revenue cycle partner that sees patients as people and communicates accordingly.
For a deeper look at this approach, view the Greenway Revenue Services Expertise Brochure
Four key areas to evaluate when selecting an RCM partner
RCM outsourcing decisions often begin in response to an urgent issue, but Rackley advised practices to first align internally on their long-term needs and goals.
“One thing people usually skip is sitting down with their leadership and understanding what the specific internal challenges are and what the goals are.”
He highlighted four areas practices should evaluate when selecting a partner:
- Expertise: Does the vendor have experience with your specialty and payer mix? Some specialties—such as neurosurgery or anesthesia—require highly specific billing knowledge.
- Transparency: Will the partner share performance insights and collaborate on problem-solving? Look for more than monthly reports—expect dashboards, KPIs, and regular check-ins.
- Technology: Consider what automation, machine learning, and workflow tools are in place to improve accuracy and speed. The right tools can significantly reduce rework and improve clean claim rates.
- Value: A low-cost option may seem appealing, but Rackley cautioned against choosing a partner on price alone. “Price is one component, but make sure you’re not missing the forest for the trees.” Prioritize ROI and long-term results.
Once a partner is selected, the next step is ensuring they deliver measurable results.
Success starts with the right metrics
Rackley encouraged practices to “measure the path to cash”—from initial claim submission to final payment—to ensure their RCM partner is delivering real improvements.
Key KPIs to monitor include:
- Clean claim rate: A high rate means fewer denials and faster payments. Top-performing practices aim for 95% or higher.
- Denial rate: Monitoring your initial denial rate—ideally between 7–8%—can help flag issues with documentation, eligibility, or coding.
- Days in A/R or aging over 90/120 days: Aging metrics give a clear view of delayed revenue and help practices target follow-up efforts more effectively.
- Cash collected vs. expected reimbursement: This is the ultimate measure of performance. Having a benchmark for what you should be paid—based on contracts or historical trends—is critical to tracking success.
Compliance is a shared responsibility
Staying up to date with payer and regulatory changes requires constant attention. At Greenway, Luz explained, this responsibility is shared across departments—not siloed.
The company follows a five-step process: identify changes, assess relevance and impact, document action needed, train teams, and perform quality checks. This structured approach helps reduce the risk of compliance-related denials or penalties.
“Ensuring that billing stays aligned with payer requirements and regulatory requirements is a full-time job for a team,” Luz said.
For practices, outsourcing to a partner that proactively monitors and responds to changes helps safeguard both revenue and reputation.
Technology is transforming how RCM work gets done
Automation and AI are no longer optional—they’re essential to modern revenue cycle operations. Rackley shared how Greenway is using these technologies to offload manual work and bring new intelligence to billing workflows.
“All of it has to do with automation and AI,” he said. “It’s completely reshaping how we think about RCM at Greenway.”
Bots are now verifying eligibility, flagging missing information, and initiating appeals with limited human input. AI is being used to detect denial trends and recommend actions before a claim is even submitted.
“It’s not just about speed,” Rackley said. “It’s about what intelligence can bring back to you.”
The result? Higher clean claim rates, reduced delays, and more time for staff to focus on higher-value tasks.
Final advice for practices considering outsourcing
For organizations considering the shift to outsourcing, Luz offered a simple framework: define your objectives, evaluate vendors thoroughly, and commit to ongoing communication.
“Communicate, communicate, communicate,” he said.
Rackley also emphasized the value of talking to other practices: “Ask for a reference and see what their responsiveness, reporting, and performance has been.”
Outsourcing RCM is no longer a tactical decision—it’s a strategic move that can transform your financial performance and patient experience. Greenway Revenue Services combines deep expertise, advanced technology, and a people-first approach to help your practice thrive in today’s complex healthcare landscape. Contact us today to discover how Greenway can become your trusted RCM partner.
