If you find it more difficult to manage 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
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
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
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 inhouse
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
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.