How better workflow ownership, clearer reporting and dedicated RCM support can help healthcare practices manage revenue without continuously expanding their internal teams.
When collections slow down, one of the first solutions a healthcare practice may consider is hiring another medical biller.
It seems reasonable. More claims to process, more denials to resolve and more outstanding accounts should mean more people are needed to handle the workload.
But what happens when the team is already busy and payments are still taking longer than expected?
The problem may not be staffing alone. It may be how work moves through the revenue cycle.
A billing department can process hundreds of claims, make dozens of follow-up calls and maintain a full workload without necessarily improving the speed at which outstanding revenue gets resolved.
More activity doesn't always mean better revenue cycle performance.
The Real Problem May Be Between the Workflows
Revenue cycle management involves several connected stages, from eligibility verification and claim preparation through submission, payment posting, denial management and accounts-reivable follow-up.
A delay at one stage can create additional work somewhere else.
Consider three examples.
Before claim submission: Incomplete patient information, unresolved eligibility questions or missing documentation can prevent a claim from being submitted correctly or on time.
After submission: A claim may require payer follow-up, but without a clearly assigned owner or next-action date, it can remain unresolved while newer claims continue moving through the system.
After a denial: The billing team may identify the issue, but resolving it could require information from another department. If responsibilities and escalation procedures are unclear, the claim can continue aging.
In each situation, hiring another person might increase available working hours. It doesn't automatically resolve the underlying handoff problem.
This is why effective RCM management requires looking beyond the size of the billing team.
A Claim Should Never Be Left Without a Next Step
One of the most useful questions a practice manager can ask is:
Who is responsible for moving this claim forward?
For every unresolved claim, there should be clarity around its current status, the person or team responsible, the next required action and the expected follow-up date.
That sounds straightforward, but maintaining this visibility becomes harder as claim volumes increase, payer requirements vary and multiple people become involved.
A stronger workflow gives the billing team clear ownership of routine work while defining when an issue needs management, clinical or coding input.
The objective isn't to create more reporting for its own sake. It's to prevent claims from sitting in queues simply because nobody is certain what should happen next.
Measure Revenue Cycle Progress, Not Just Productivity
Claim volumes and completed tasks can help managers understand workload, but they don't tell the full story of billing performance.
Practices should also examine how effectively claims are progressing toward resolution and appropriate reimbursement.
Useful measures include:
- Initial denial rate: Which claims are being denied, and what are the recurring reasons?
- Days in accounts receivable: How efficiently is outstanding revenue progressing through the collection cycle?
- A/R aging: Which balances are becoming older, and which payers or workflows require attention?
- Denial resolution time: How long does it take to move a denied claim toward a final outcome?
- Follow-up effectiveness: Are assigned actions resolving issues, or are the same accounts being reviewed repeatedly without progress?
The Healthcare Financial Management Association (HFMA) provides industry-standard revenue cycle measures, including denial and accounts-receivable indicators, that can help organisations establish more consistent reporting.
The important point is to define each metric consistently and review trends against the practice's own baseline.
A team should be able to explain not only how much work was completed, but what that work accomplished.
When Does Additional RCM Capacity Make Sense?
There are situations where adding medical billing resources is absolutely the right decision.
A practice may be experiencing sustained increases in patient volume, a growing A/R backlog, insufficient payer follow-up coverage or limited internal capacity to handle routine billing administration.
The question is whether the extra capacity will be connected to a defined workflow.
For example, a dedicated billing resource might take responsibility for a specific payer queue, eligibility checks, claim preparation, denial follow-up or an agreed portion of accounts receivable.
A broader RCM arrangement may be appropriate when a practice needs coordinated support across multiple stages of the cycle.
Neither arrangement should be judged only by the number of people assigned.
Before expanding a billing team, practice leaders should understand the actual bottleneck, the scope of work being transferred, the reporting requirements and how results will be reviewed.
Adding capacity works best when that capacity has a clear purpose.
What Healthcare Practices Should Expect From an RCM Partner
Outsourcing medical billing does not remove the need for oversight. It changes how responsibilities are shared and how the work is managed.
Before engaging an external RCM team, a healthcare organisation should be comfortable answering five questions:
- Which billing activities will the external team handle, and which decisions remain with the practice?
- What experience and training are required for the practice's specialty, payer mix and systems?
- How will unresolved claims, denials and escalations be tracked?
- What reports will be provided, and how frequently will performance be reviewed?
- What privacy, security, access-control and contractual safeguards must be established before work begins?
Healthcare billing also requires careful handling of protected health information. Where applicable, the HIPAA Rules require appropriate business associate agreements and safeguards governing access to and use of that information.
A dependable RCM partnership needs defined scope, accountable people, secure workflows and reporting that allows the practice to remain informed.
How Squad International Approaches Medical Billing & RCM Support
At Squad International, our Medical Billing & RCM service is designed to give healthcare organisations dedicated operational capacity around their existing workflows.
Our service scope includes insurance eligibility and benefits verification, charge entry, claim preparation and submission, denial handling, and accounts-receivable follow-up.
Rather than expecting clients to adopt an entirely separate operating environment, we structure support around their practice management systems, documented processes and agreed responsibilities.
Our delivery approach begins with understanding the workload, payer mix and access requirements. The next steps involve team training, a supervised pilot with claim-level review, and ongoing reporting around accounts receivable and denials.
Depending on the operational requirement, practices can explore a dedicated RCM team or a broader percentage-based service arrangement.
The goal is not simply to add billing headcount. It's to provide dependable support while giving the practice greater visibility and control over the work.
The Bigger Picture: Better RCM Requires Accountability
A growing medical practice needs enough capacity to keep billing operations moving. But capacity alone is not a complete revenue cycle strategy.
Claims still need clear ownership. Denials still need timely attention. Payer follow-ups need structure, and performance needs to be measured consistently.
When those foundations are in place, adding dedicated resources becomes a much more informed operational decision.
For healthcare practices, the more useful question may not be “How many additional billers do we need?”
It may be:
“What is preventing our existing revenue cycle from moving more efficiently, and where would additional support make the greatest difference?”
That's the conversation worth having before making the next hiring or outsourcing decision.
Explore Medical Billing & RCM Support
If your practice or billing company needs additional capacity for claims, denial management or accounts-receivable follow-up, Squad International can help you explore a support model built around your workflow.
Explore Squad International's Medical Billing & RCM Services
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Further reading: HFMA Revenue Cycle Performance Measures and HHS Business Associate Guidance.