Revenue cycle management outsourcing for healthcare providers
Actigy BPO connects agreed front-, mid- and back-cycle tasks in your systems, with a named owner at each handoff.
Actigy BPO provides revenue cycle management outsourcing for providers and medical billing companies. Nearshore business process outsourcing (BPO) teams in Bulgaria, Romania, Poland and Ukraine coordinate agreed eligibility, coding-support, claims and payment-recording queues. The client retains clinical and financial decisions. A process audit and paid pilot define the stages, handoffs and measures before the service expands.
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Key takeaways
Actigy BPO defines the complete handoff for each agreed revenue cycle management (RCM) workstream.
- Every Actigy BPO engagement starts with a process audit and a paid pilot.
- Actigy BPO delivers from teams in Bulgaria, Romania, Poland and Ukraine.
- One assigned stage and a joined multi-stage scope are different engagements.
- The client retains treatment, coding policy, refunds, adjustments and write-offs.
- Measure approved outputs and unresolved handoffs, not just the number of tasks touched.
RCM outsourcing at a glance
Actigy BPO scopes healthcare operations in the client's existing systems. The service is not a billing platform or a transfer of clinical authority.
| Field | Actigy BPO scope |
|---|---|
| Buyer | Healthcare providers and medical billing companies. |
| Delivery | Bulgaria, Romania, Poland and Ukraine; approved locations stated in writing. |
| Coverage | Agreed operating hours, with US-business-hour shifts for calls to US payers. |
| Work model | One defined queue or connected administrative stages with explicit handoffs. |
| Price | Per full-time equivalent (FTE) by role after the process audit. |
| Start | Paid pilot with agreed inputs, review steps and acceptance measures. |
Revenue cycle management outsourcing: map each stage
Actigy BPO maps the source record, action, owner and output at each agreed stage. The front cycle covers record checks before billing. The mid cycle prepares billing data. The back cycle follows claims, payer replies and payments. The written scope names the tasks that the client assigns.
| Stage | Actigy BPO workstream | Client retains |
|---|---|---|
| Front cycle | Insurance verification services and recorded benefit questions. | Patient, treatment and clinical decisions. |
| Mid cycle | Medical coding outsourcing within approved policy, plus agreed charge-entry support. | Clinical documentation, coding policy and review of unresolved questions. |
| Claims | Preparation and submission support in the agreed medical billing outsourcing scope. | Payer-contract policy and submission authority. |
| Denials | Denial management services with evidence and next-action records. | Approval of actions outside written procedures. |
| Unpaid balances | AR follow-up services for assigned accounts receivable (AR). | Adjustments, write-offs and refund decisions. |
| Payments | Payment posting services and unmatched-item reporting. | Financial sign-off and the authority to move money. |
Actigy BPO can manage a selected stage without taking over the whole cycle. A joined scope requires agreed inputs from every retained team. An eligibility check cannot fix a missing clinical record, and a posted payment does not by itself explain an underpaid claim.
How can billing companies outsource revenue cycle work?
Actigy BPO can operate agreed queues inside a billing company's existing systems and procedures. The client retains its provider relationship, approval policy and customer handoffs. Specify which records the team receives, which completed outputs it returns and who handles exceptions. The engagement adds managed operating capacity without requiring a replacement billing platform.
How Actigy BPO connects the workflow
Actigy BPO starts the process audit with a workflow map and sample records. The standard operating procedure (SOP) then links tasks that sit in separate queues. Each key performance indicator (KPI) names its source, time span and what it measures.
- Trace the current cycle. Identify where work stops, repeats or waits for a decision.
- Set the scope. List assigned queues and tasks that remain with the provider or billing company.
- Define handoffs. Agree required fields, completion evidence, queue owners and escalation deadlines.
- Prepare access and training. Test client-system permissions and approved procedures before the pilot.
- Run a paid pilot. Test the chosen claim group and its retained-team handoffs.
- Review quality. Use maker-checker quality assurance (QA), samples and a documented correction process.
- Expand approved stages. Add scope only after the pilot meets the agreed checks.
Actigy BPO keeps client-owned procedures, access rights and open-item records clear during handover. An exit plan names the records, queue status and tasks to return. The client can review that plan before adding more work.
Measure benefits without promising an outcome
Actigy BPO tests the benefits of outsourcing RCM against a defined baseline. The goal is work the client can check and handoffs it can track. Results depend on scope, payer replies and source records. A joined service does not itself increase cash or remove provider review.
| Intended improvement | Measure to define | Boundary to retain |
|---|---|---|
| Claim quality | Clean claim rate and documented correction causes. | State the submitted-claim group and denominator. |
| Faster handoffs | Time between a complete input and the next accepted output. | Separate missing client inputs from processing time. |
| Backlog visibility | Unresolved claims by age, payer and next-action owner. | Do not count an administrative closure as cash. |
| Payment-record accuracy | Posting corrections and unresolved matching items. | Keep refund and adjustment approval with the client. |
| Operating cost | Provider fee plus retained staff, tools, review and transition work. | Compare like-for-like scope instead of headline staffing rates. |
Risks, decisions and patient information
Actigy BPO records each gap instead of passing incomplete work to the next queue. Conflicting payer rules go to the policy owner. Missing care records return to the provider. Before sending a claim again, the team checks its history.
Actigy BPO prepares claims and appeals; the provider keeps clinical, coding and payer-contract decisions. The team does not determine medical necessity, approve patient care, release payments or move money. The client approves write-offs, adjustments and refunds.
Actigy BPO works on protected health information (PHI) only in the systems the client approves. Roles, access logs and review records support the agreed controls. Data handling for US healthcare clients, including HIPAA requirements, is agreed in the written scope and data processing terms.
The client confirms payer restrictions before offshore access starts. Restricted work does not enter the pilot. The written scope and data-processing terms identify locations, subprocessors and transfer requirements.
What does healthcare RCM outsourcing in Europe involve?
Actigy BPO delivers from Bulgaria, Romania, Poland and Ukraine under the client's agreed access and coverage terms. The first three locations are EU hubs; Ukraine is outside the EU. Match the work location to the records and payer rules. A team in Europe still needs approval before it can access patient data.
Coverage, pricing and retained costs
Actigy BPO teams in Central and Eastern Europe cover the full UK business day and the US morning. Calls to US payers run during US business hours. The written scope sets the shift pattern and escalation cover. Later hours and weekend work need an agreed plan.
Actigy BPO prices most services per full-time equivalent (FTE) by role and sends a written quote after the process audit. Market offers can use other fee models; compare the included stages, review work and exclusions before comparing prices. No collection-based fee is implied by this service page.
Use the medical billing and coding salary report as hiring context, not as a quote for managed delivery. A staff salary excludes the same provider-management, training and transition costs that a service proposal must explain.
| Responsibility | Actigy BPO managed team | In-house team | Freelancer or staffing agency |
|---|---|---|---|
| Work ownership | Defined queues and handoffs in written scope. | Client manages the cycle. | Check who manages assigned people and tasks. |
| Review | Documented QA and escalation routes. | Client owns the review process. | Included review depends on the agreement. |
| Decisions | Clinical and financial authority stays with the client. | Client retains authority. | Client retains authority. |
| Exit | Client-owned procedures and queue handover. | Internal handover process. | Agree records, access removal and replacements. |
Published telehealth evidence
Actigy BPO reported a 97.8% clean claim rate and 31% lower days sales outstanding (DSO) for one digital health provider. See the telehealth RCM case study. Actigy BPO-reported, anonymized, not independently audited. Results depend on scope.
The case covers a joined workflow. It does not prove a hospital-wide service or promise a result for a new client. A proposed RCM scope needs its own baseline, work map and checks to pass during the pilot.
When Actigy BPO fits RCM outsourcing
Actigy BPO fits when a provider or billing company needs connected administrative queues, clear records and retained decision control.
Actigy BPO is not the right fit when the buyer needs clinical authority, a new software platform or unrestricted access that its payer contracts prohibit.
RCM outsourcing companies: how to compare providers
Actigy BPO offers a defined scope, not a claim to handle every task. Compare stage owners, system access, retained approvals, report definitions and exit terms. Ask each provider to trace a sample problem from its first record to the client's decision. That work map explains more than a broad promise.
Specialist billing and verification queues
Actigy BPO uses service-specific checklists within the broader RCM map. Choose the relevant specialty page for its scope and limitations. Those pages do not replace the provider's approved clinical and payer requirements.
- DME billing services: equipment records, claims and documentation follow-up.
- Dental insurance verification: appointment-related benefits breakdowns.
- Telehealth billing services: virtual-care workflows and provider handoffs.
- Mental health billing services: an agreed mental-health billing queue.
- ABA billing services: a defined applied behavior analysis billing scope.
- Medical transcription outsourcing: adjacent record-preparation support with clinician review retained.
RCM outsourcing questions
Actigy BPO separates an operating scope from a software product or a promise to take every provider responsibility.
What is revenue cycle management outsourcing?
Revenue cycle management outsourcing assigns defined administrative stages of healthcare billing to an external operating team. Actigy BPO provides agreed eligibility, coding-support, claims, denial, AR and posting work in client-approved systems. The written scope names the stages, inputs and decision owners. A client can assign one queue or a joined workflow. Clinical care, coding policy, payer contracts and financial approvals remain with the provider or billing company.
What are the benefits of outsourcing revenue cycle management?
Actigy BPO tests benefits such as clearer queue ownership, documented quality checks and visible handoffs during a paid pilot. The client defines how to measure claim quality, processing time, unresolved balances and total operating cost. Outcomes depend on the input records, scope and payer responses. A service fee does not establish a saving or collection improvement by itself. Compare retained client work and transition costs as part of the same decision.
Which RCM steps should stay in-house?
The client retains clinical decisions, coding policy, payer-contract decisions and approval of refunds, adjustments and write-offs. Actigy BPO prepares agreed administrative work and routes exceptions to those decision owners. The client also approves record access and any restriction imposed by a payer or government program. A workflow can be managed externally while those approvals remain internal. The process audit identifies who must be available at each retained handoff.
How do you compare RCM outsourcing companies?
Actigy BPO recommends comparing written scope, review controls, access requirements, coverage and retained client responsibilities before the headline fee. Ask how the proposed team records unresolved claims and separates a completed task from a collected payment. Review source evidence and its limits, then agree a pilot baseline. An exit plan must identify queue records, client-owned procedures and access removal. These checks apply whether the client outsources one stage or connects several.
How is RCM outsourcing priced?
Actigy BPO prices RCM outsourcing per FTE by role after the process audit. The quote depends on the assigned stages, volume, review requirements, client systems and coverage hours. Other market proposals can use transaction or collection-based fees, so compare what each price includes. Retained provider review, software and transition work remain part of total cost. A paid pilot tests the agreed scope without promising a universal savings percentage.
Scope the first connected workflow
Actigy BPO needs your current stages, approximate volume, systems and the handoff that causes the most rework. Send business details through the form below. Patient records and payer credentials belong in approved systems after access and processing terms are agreed.
Page updates
Actigy BPO published this service guide on October 4, 2026, with scope, controls and buyer questions.
Scope a pilot
What happens next
The team reviews the workflow before proposing a written scope. You decide whether to start a paid pilot after reviewing it.