IF YOU FIND IT MORE DIFFICULT TO MANAGE THE ENTIRETY OF YOUR MEDICAL PRACTICE WHILE MAINTAINING THE COMPLEXITY AND EFFICIENCY OF YOUR REVENUE CYCLE MANAGEMENT, YOU SHOULD CONSIDER OUTSOURCING.
Saves Time and Resources
It takes a great deal of time to hire, train, and maintain a revenue cycle management (RCM) staff. With the ever-changing regulations and protocols in the healthcare industry, outsourcing relieves your business of these burdens and allows you to focus on the core of your medical practice.
Enhances Revenue Generation
An RCM service will be able to generate a higher practice income through efficiencies of scale, broader experience with payors, resources dedicated to denial management, and self-pay follow-up, even after calculating the fees.
Decrease Days in A/R
Lack of follow up is a major contributor in lost revenue. Contributing factors such as timely filing issues, contractual allowances and write offs result in an increase in days in A/R.
A contemporary RCM service will provide customized monthly reports and analytics that offer a deeper look at key metrics, allowing the organization to make better strategic decisions. This should include provider productivity, coding methods, resource management, enhanced patient care and myriad other practice specific ones.
Detailed Information (Cost/Utilization Patterns to Assist in Contract Negotiations)
Negotiating with payors in today’s environment is not only a tedious process, but puts a tremendous strain on providers and their management team. Having detailed, empirical historical information on an ongoing basis is a competitively enabling foundation when negotiating contracts.
A RCM should be your “Business Partner”, not your “Billing Company”. Clients should have dedicated personnel to handle your account almost as if they were your own employees. —6443
Single Point of Accountability
When outsourcing, you have an accredited organization focused on the highest level of performance while providing checks and balances, making sure there are no inconsistencies. This allows for a more efficient billing process that offers a one stop solution.
Cost of Building an Internal Billing Operation
The costs and personnel complexities associated with implementing and running an internal billing operation is very high. A billing administrator is required to hire, train, certify and carry out a compliance plan. The average cost of recruiting, hiring and training a new employee is $3,500 (that does not include the decreased production caused by turnover). Technology, (hardware/software) resources, salary, benefits and office space are just a few contributing factors to the overwhelming expense of in house billing.
With the complex regulatory environment in the healthcare industry, the demands for billing knowledge and experience have become overwhelming for healthcare providers. Full service billing services are in demand partly because of their efficient administrative processes, HIPAA compliance, and their ability to stay contemporary with regulations and requirements.
End to End Management of IT includes the ability to meet the demand for skilled IT personnel, continuous assessment of your application (Industry Standards, HIPAA), hardware, network, heating, ventilation, HVAC, power, security, staffing, policies, procedures, upgrades, backups, monthly maintenance fees and the ability to integrate various systems and deploy new technologies.
Offsite backups are required by HIPAA. And, an internal data backup plan is also required. You must establish and implement procedures to create and maintain retrievable exact copies of electronic protected health information.
Billing Business is Different From Your Core Business
Medical Billing is complex and requires 100% of your staff members time. Practices are looking to full service billing partners to allow the practice to focus on quality patient care.
Continuous Change in Healthcare Regulations
With the constant change in health regulations, providers no longer have the time and resources to dedicate to reading material, checking websites, interacting with payers and attending industry seminars. A quality RCM service staff will stay current on all of the aforementioned disciplines.