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Why Many Providers Are Frustrated With RCM Services?

RCM Services Problems Healthcare Professionals Face

Healthcare professionals are asking direct questions in online forums: “Who is unhappy with RCM services and why? Curious if anyone else has been facing issues with getting claims paid on time, having transparency in the process, or checking eligibility.”

The responses reveal patterns that practices nationwide are experiencing with their revenue cycle management vendors.

“I Hired a Biller and There Was No Check and Balance”

One healthcare professional shared their experience: “I was running into issues before but i am doing good now. I hired a biller first and there was no check and balance on him so things went south pretty soon after. I had to fire him and started working on some of the issues myself like incorrect routing on claim and claim in rejection bucket but it was too much for me.”

The lack of oversight created problems that compounded quickly. Without proper monitoring systems, incorrect claim routing and mounting rejections became overwhelming. The practitioner eventually “hired a company on percentage, they were able to clear most of issues within a month and they also check eligibility 24 to 48 hours before appointment.”

The transition worked: “I am now starting to receive payments on those claims and it think 80-90% if those claims will get processed because there were some that were out of filing limit.”

“OMEGA – The Worst. I Fired Them After 1 Year”

Multiple healthcare professionals report negative experiences with offshore RCM vendors. One physician owner stated bluntly: “I have used OMEGA….the worst. I fired them after 1 year. They’re based in India and are using clerical workers with no medical knowledge.”

The specific errors were clinical in nature: “couldn’t tell difference between PA vs MD attestation. Central Line vs Arterial line. Coding issues…too many clerical issues to name.”

Another practitioner confirmed the same vendor problems: “Omega is charging $30k for reports. Our denial rate has gone up exponentially. They have untouched denials from last year. Routing is like a broken GPS. Turn around time is at least a week for any correspondence.”

The financial impact was severe: “A lot of our denials expired and we didn’t find out until much later.”

“Outsourcing Overseas to Very Poor Countries – Quality Has Gone Drastically Downhill”

Healthcare professionals identify a systemic industry problem: “A lot of RCM services are outsourcing overseas to very poor countries, and the quality of the services they provide has gone quite drastically downhill. The customer service/call centers are terrible, and the quality of work is garbage.”

The root cause is clear: “All of these companies are doing it to save loads of money in salaries and benefits, but unfortunately, I have yet to see an outsourced team provide quality service. Instead of giving in to the increasing demands US employees were asking for, like being paid a liveable wage, getting better benefits, and annual raises/bonuses.”

The distinction matters. Not all offshore operations are equal. Healthcare professionals need teams with actual clinical backgrounds, not just clerical workers processing claims they don’t understand.

“Transparency: None of Them Could Tally My Denials Accurately”

A physician owner with 10 years of experience trying multiple RCM vendors identified the core problems across platforms: “I have tried AthenaOne, ECW, AdvMD and Omega and another company in Pakistan.”

The transparency issue was universal: “None of them could tally my denials accurately and neither did they chase after my denials (<25% for a 20 provider group) so we lost hundreds of thousands $. You need to understand your denials and be realistic. I don’t expect my biller to bill EVERYTHING but at least try and show me some progress.”

Data reporting was equally problematic: “You need a company to give you monthly updates in reports. understand the performance of your individual CPT and insurance data metrics so you know how to incentive your providers.”

Communication failures compounded everything: “I prefer communication via email. I don’t expect a 24 hour response…but at least 2-3 days. AthenaOne took 1 week for anything. ECW didn’t even have a true support. Omega – I couldn’t understand their accent half the time.”

“Hidden Fees, Unexpected Charges, and Inability to Forecast Revenue”

Beyond operational failures, healthcare professionals report financial unpredictability: “Many practices report their RCM vendors provide poor communication about claim issues, fail to share detailed performance metrics, and don’t proactively identify recurring denial patterns.”

The financial structure creates additional problems: “Practices are frustrated by hidden fees, unexpected charges for ‘special’ handling of claims, and the inability to accurately forecast revenue due to inconsistent collection rates.”

Staffing instability makes everything worse: “These issues are compounded by high staff turnover at RCM companies, leading to knowledge gaps and service disruptions.”

Virtual RCM Specialists with Healthcare Backgrounds

Healthcare professionals discovering better alternatives are choosing virtual revenue cycle management specialists with actual clinical training. The difference comes down to expertise versus clerical processing.

Staffingly’s RCM teams include professionals with Medical Doctor, PharmD, Nursing, and MHA degrees from India and Pakistan, with many holding U.S. pharmacy licenses. This healthcare education background means specialists understand the clinical difference between “PA vs MD attestation” and “Central Line vs Arterial line” that clerical workers miss.

The pricing structure provides transparency that percentage-based models don’t: starting at $9.50/hour, practices pay under $2,000 monthly per specialist versus $4,500+ base salary plus payroll taxes and benefits for local staff, or unpredictable percentage fees that increase as collections grow.

HIPAA, SOC 2, and ISO 27001 compliance provides enterprise-level security with fully managed oversight. No clerical workers processing claims they don’t understand. No week-long response times. No untouched denials expiring while vendors collect fees.

Monthly Performance Data You Can Actually Use

Healthcare professionals emphasize the importance of actionable metrics: understanding denial patterns, CPT-level performance, and insurance-specific data that drives provider incentives and practice decisions.

Virtual billing specialists provide detailed monthly reports showing exactly where revenue is succeeding and where denials need attention. Claims aren’t just submitted and forgotten – specialists track every claim through payment, identify patterns in denials, and proactively address issues before they become expensive problems.

The systematic approach includes eligibility verification 24-48 hours before appointments, proper claim routing from the start, and immediate attention to rejection buckets. No “broken GPS routing.” No discovering expired denials months later.

Real Healthcare Professionals Managing Your Revenue Cycle

The physician owner who tried “more than a dozen companies/softwares/agencies” eventually found what worked. Another practitioner reported: “I was really unhappy with my old billing team—they were unresponsive, didn’t handle collections, and left me dealing with tons of claim issues due to their errors.”

After switching to specialized virtual RCM services: “They’re responsive, handle everything efficiently, and my practice has achieved a 98% collection ratio while hitting the HIGHEST revenue we’ve ever seen.”

With a 4.9-star rating from over 119 reviews, Staffingly provides the healthcare expertise and transparent communication that practices need. Virtual specialists work as extensions of your team, not distant vendors processing claims without understanding the clinical context.

Stop Losing Money to RCM Services That Don’t Deliver

Healthcare professionals are tired of “no check and balance,” expired denials, and offshore teams that “couldn’t tell difference between PA vs MD attestation.” Your practice deserves RCM specialists with actual healthcare backgrounds who understand the clinical and billing complexity of medical claims.

30-Day Risk-Free Trial

✓ Virtual Medical Billing & Coding Specialists – Healthcare professionals with MD, PharmD, and Nursing backgrounds who understand clinical documentation

✓ Transparent Performance Reporting – Monthly metrics showing denial patterns, CPT performance, and insurance-specific data you can actually use

✓ Systematic AR Follow-up – No more “untouched denials from last year” or expired claims discovered months later

Starting at $9.50/hour. Under $2,000 monthly versus $4,500+ plus payroll and benefits for local staff. Certificate of liability insurance provided.

Get the transparency, expertise, and results that offshore clerical teams can’t deliver. Join practices that chose healthcare professionals over generic billing services.

HIPAA-compliant. SOC 2 and ISO 27001 certified. Healthcare-specialized teams with clinical backgrounds.

What Did We Learn?

• Providers are frustrated with RCM services mainly due to denied claims, delayed reimbursements, lack of transparency, and hidden costs.

• Communication gaps between providers and RCM vendors often lead to poor claim follow-ups and revenue leakage.

• Outsourcing RCM can bring efficiency, but without proper oversight it risks losing control over billing accuracy and compliance.

• Technology limitations and reliance on outdated systems add to provider dissatisfaction.

• The path forward is finding RCM partners who focus on accountability, proactive denial management, clear reporting, and aligning financial goals with patient care priorities.

What people are Asking?

1. What is Revenue Cycle Management (RCM) in healthcare?
RCM is the process of managing claims, payments, and revenue generation in healthcare. It includes patient registration, insurance verification, coding, billing, denial management, and collections.

2. Why are providers unhappy with RCM services?
Providers often face issues like delayed reimbursements, poor denial handling, lack of transparency, high outsourcing costs, and weak communication from RCM vendors.

3. How do RCM service failures affect patient care?
When claims are denied or delayed, providers may experience financial stress, which can reduce resources for patient care and increase administrative burdens on staff.

4. Is outsourcing RCM always a bad idea?
Not necessarily. Outsourcing can reduce workload and improve efficiency, but it requires choosing the right partner who provides clear reporting, compliance assurance, and timely follow-ups.

5. What should providers look for in a reliable RCM partner?
Key factors include denial management expertise, transparent reporting, use of advanced technology, strong compliance standards, and responsive communication.

Disclaimer

For informational purposes only; not applicable to specific situations.

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Email: support@staffingly.com

About This Blog: This Blog is brought to you by Staffingly, Inc., a trusted name in healthcare outsourcing. The team of skilled healthcare specialists and content creators is dedicated to improving the quality and efficiency of healthcare services. The team passionate about sharing knowledge through insightful articles, blogs, and other educational resources.