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Healthcare revenue cycle management encompasses every administrative and financial process that captures, manages, and collects patient service revenue — from the moment a patient schedules an appointment through final payment posting and reconciliation. RCM is the financial engine of every healthcare organization, and when it underperforms, the consequences are immediate: denied claims, extended accounts receivable, cash flow pressure, and clinical staff diverted from patient care to chase payments.
US hospitals lose $262 billion annually to preventable claim denials according to the Healthcare Financial Management Association, and 97% of healthcare organizations now outsource at least one revenue cycle function. The complexity of payer rules, coding requirements, prior authorization mandates, and compliance regulations has made in-house RCM unsustainable for most providers without specialist infrastructure.
SkyCom's healthcare RCM outsourcing delivers a complete, HIPAA-compliant revenue cycle operation — from front-end patient access through coding, claims submission, denial management, and payment posting — with bilingual nearshore teams that reduce costs by 50–70% while improving every financial KPI that matters.
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Find quick answers to common questions about partnering with SkyCom for LATAM nearshore services.
End-to-end revenue cycle management — patient registration, eligibility verification, prior authorization, medical coding (CPT, ICD-10, HCPCS), charge capture, claims submission, denial management and appeals, payment posting, ERA/EOB reconciliation, AR follow-up, patient billing, and financial reporting. We cover front-end, mid-cycle, and back-end RCM functions.
Three layers: front-end denial prevention through three-touch eligibility verification before every encounter; mid-cycle accuracy through certified coders with specialty-specific QA; and back-end recovery through structured denial analysis, root-cause categorization, and aggressive appeals management. This drives denial rates 30–40% below in-house benchmarks.
Consistently above 95%, versus the 85–90% typical for in-house billing teams. For an organization submitting 500 daily claims, that 5–10 point improvement prevents 25–50 denied claims every day — directly accelerating cash flow and reducing rework.
Yes — our coding team maintains CPC, CCS, and CPMA credentials with specialty-specific training across cardiology, orthopedics, oncology, gastroenterology, general surgery, primary care, behavioral health, and more. Continuing education and annual recertification are built into our operations.
HIPAA, PCI DSS, SOC 2 Type II, and ISO 27001 certified. All financial and clinical data encrypted using AES-256, role-based access with MFA, BAAs with all clients, annual HIPAA training, and regular third-party audits. Access terminated within one hour of staff separation.
Epic, Cerner (Oracle Health), MEDITECH, athenahealth, eClinicalWorks, NextGen, AdvancedMD, Kareo/Tebra, and proprietary practice management systems. Our teams work directly in your platform — no separate billing system required.
6–10 weeks for a phased go-live, depending on complexity. We stage by function — registration and eligibility first, then coding and claims, then AR and denial management — with parallel processing and quality gates before full transition. No disruption to cash flow during transition.
Clean claim rates above 95%, denial rates 30–40% below baseline, net collection ratios above 98%, days in AR reduced by 15–25 days, and 50–70% lower RCM operational costs. Most clients see measurable improvement within the first 90 days.
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