4 Signs that show need of outsourcing Revenue cycle functions

Are you one of the many physicians who are wondering whether to outsource their billing and revenue cycle management functions? You’ve outsourced payroll, but now that you are considering outsourcing RCM, you might hesitate even more than with other aspects of practice management that have been done in-house up until now.

You are not alone in experiencing this tension between handling a task yourself or deferring to an outside party.

Outsourcing your finances may seem like a good option at first. Include some time for careful consideration and research before making any decisions

Financial institutions can be intimidating, and there is always the possibility of foul play in entrusting others with your money.

Entrepreneurship doesn’t just involve managing money well; it also involves knowing what level of control you need over your life while still being able to practically keep track of all the details involved.

The Revenue Cycle Management (RCM) department deals with all billing and payment issues. This includes confirming eligibility and coverage, assuring accurate coding for each patient visit or service performed to ensure maximum reimbursement from insurance companies- all tasks that are necessary before you can be paid!

Billing can be time consuming but is necessary to take care of the essentials before you’re paid. To ensure your eligibility and coverage are correct, you should confirm both with your insurance company. You also need to make sure that the code you use for every procedure on every patient or for any product bought at the patient’s request is accurate (for example, if a patient requires medicine, you need to make sure the code used is the same one that is accepted by your insurance company). To do this, you will have to log into your insurance company’s website and check in detail. And although it may be a lot of work, it’s worth it because if you don’t take these steps, you won’t be compensated for your services.

Let’s talk about the benefits of outsourcing and how you can take advantage of them.

How can the billing cost be reduced?

Often it is thought that outsourcing the responsibilities of an RCRM is more costly than keeping these functions in house. However, what must be considered are all costs, including payroll, benefits and overhead expenses—such as time spent on breaks or casual inequities due to inefficiencies within your company for doing so. In order to maximize practice potential, real estate costs associated with in-house billing staff, and other overhead items must be considered. This will allow for more profitable use of resources by chasing down dollars already earned rather than underutilizing them as they currently exist on paper only and not having any impactful value towards increasing revenue or likelihood of success among clients.

Outsourcing to a bill collector service can eliminate the need for in-house billing staff.

The cost and strain of employing in-house personnel are too high, making it difficult to provide extra services and infrastructure when that real estate could otherwise generate revenue at a much lower price point than what’s necessary with outsourced labor.

High staff turnover

Keeping your in-house billing staff can be a challenge, but for practices with an in-house staff turnover rates can become overwhelming. An in-house billing staff relies heavily on many roles being performed by one person, which means your company faces high risks for missed payments or denials of service if something goes wrong at every turn.

It would be difficult to manage revenue cycles without relying extensively on human resources. These individuals are crucial during such delicate times.

Lack of effective denial management processes is a problem

For a medical office to be healthy, it needs policies and follow-through on those policies to handle insurance denials or appeals. If a practice is receiving more than 4% denials, the practice doesn’t have these policies in place. The practice also doesn’t have the necessary infrastructure and resources to carry out these policies.

To streamline the process of denial, quality control is one piece of advice I would give to all those who strive to deny claims more efficiently.

In order to identify potential issues and provide corrective action, have a plan in place.

Proper denial management protocols will allow your practice to prevent or catch any system problems or acute cases that could arise before they become serious setbacks with regards to attending ability to deliver front-line patient care effectively.

You are starting a new medical practise

The current state of American healthcare cannot support the current number of patients and physicians. This is because many physicians are becoming disenchanted with the process of billing patients, which often requires them to research insurance carriers or bill individuals directly without any knowledge about how this works beforehand.

For example, selecting which people get reimbursed after a car accident is not something you have time to do in between your other obligations at law school, such as meeting with clients during office hours.

Outsourcing constitutes a convenient, effective means of offloading everyday responsibilities. However, it is imperative to personally vet the outsourcing provider in order to ensure that the RCM partners have ample experience in handling nuance and special client requests.

Conclusion

Finding the right RCM partner can take some time. You want to make sure your RCM knows their stuff, and is willing to help your practice grow into the future.